AVERA MCKENNAN (NPI# 1831230408) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831230408 |
| Entity Type | Organization |
| Organization Name | AVERA MCKENNAN |
| Other Organization Name | AVERA TEA MEDICAL CLINIC |
| Practice Address |
725 E Figzel Ct Suite 100 Tea SD 57064-2276 |
| Mailing Address |
Po Box 90608 Sioux Falls SD 57109-0608 |
| Practice Telephone | 6053689899 |
| Mailing Telephone | 6057828313 |
| Mailing Fax Number | 6057828386 |
| Enumeration Date | 2007-02-08 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | RONALD J FARR (SR VICE PRESIDENT OF FINANCE) |
| Authorized Official Telephone | 6053689899 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| X | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers | ||
| X | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers |
| Other Name | Type Code |
|---|---|
| Avera Tea Medical Clinic | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154979805 | Avera Mckennan | Substance Abuse Rehabilitation Facility | 6140 S Curae Lane, Sioux Falls, SD 57108-3047 | 2019-08-27 |
| 1205311628 | Avera Mckennan | Pharmacy | 6100 S Louise Ave Ste 1100, Sioux Falls, SD 57108-6021 | 2018-10-02 |
| 1316463219 | Avera Mckennan | Pharmacy | 1200 S. 7th Avenue, Suite 101, Sioux Falls, SD 57105 | 2017-08-22 |
| 1851848444 | Avera Mckennan | Durable Medical Equipment & Medical Supplies | 2100 S Marion Road, Ste 125, Sioux Falls, SD 57106-3645 | 2016-09-01 |
| 1295187417 | Avera Mckennan | Psychiatry & Neurology | 6709 S. Minnesota Ave., Ste. 103, Sioux Falls, SD 57108-2593 | 2016-07-12 |
| 1669871000 | Avera Mckennan | Durable Medical Equipment & Medical Supplies | 3820 N Potsdam Ave Ste 2, Sioux Falls, SD 57104-7057 | 2014-08-21 |
| 1922413806 | Avera Mckennan | Clinic/Center | 400 2nd Ave, Brookings, SD 57006 | 2014-06-30 |
| 1629499132 | Avera Mckennan | Occupational Therapist | 1601 W 44th Pl, Sioux Falls, SD 57105-6376 | 2013-12-31 |
| 1700146396 | Avera Mckennan | Clinic/Center | 1035 South Highline Pl, Ste #4, Sioux Falls, SD 57110 | 2012-05-17 |
| 1467711739 | Avera Mckennan | Pharmacy | 1301 S Cliff Ave Ste 225, Sioux Falls, SD 57105-1068 | 2012-05-08 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | AVERA MCKENNAN | 1325 S Cliff Ave, Sioux Falls, SD 57105-1007 |
| Iowa Business Entities | AVERA MCKENNAN | 1325 S. Cliff St., Sioux Falls, SD 57105 |
| System for Award Management (SAM) Entities | AVERA MCKENNAN HOSPITAL & UNIVERSITY HEALTH CENTER | 1325 S Cliff Ave, Sioux Falls, SD 57105-1007 |
| Street Address |
725 E FIGZEL CT SUITE 100 |
| City | TEA |
| State | SD |
| Zip Code | 57064-2276 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093780488 | Christopher William Lane | Chiropractor | 725 E Figzel Ct, #104, Tea, SD 57064-2276 | 2006-02-21 |
| 1861415127 | Pamela G Elshere | Physician Assistant | 725 E Figzel Ct, Suite 100, Tea, SD 57064-2276 | 2006-07-26 |
| 1376519116 | Avera Mckennan | Clinic/Center | 725 E Figzel Ct, Suite 100, Tea, SD 57064-2276 | 2006-02-23 |
| 1194790568 | Wayne Robert Huber Jr. | Chiropractor | 725 E Figzel Ct, #104, Tea, SD 57064-2276 | 2006-02-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376169797 | Adam Fjeldheim | Dentist | 605 E. Brian St., Tea, SD 57064 | 2020-06-22 |
| 1275946188 | Perspective Health Chiropractic & Wellness | Chiropractor | 910 N. Main Ave., Suite 105, Tea, SD 57064 | 2014-06-09 |
| 1508078684 | Nicholas J. Shawd D.d.s., P.C. | Dentist | 725 E. Kevin Dr., Ste. 101, Tea, SD 57064 | 2007-05-03 |
| 1518083757 | Laura Marie Koele | Chiropractor | 710 E First Street, Tea, SD 57064 | 2007-03-21 |
| 1851328751 | Reilly Pharmacy LLC | Pharmacy | 720 E. First Street, Tea, SD 57064-0487 | 2006-06-27 |
| 1518355841 | Melissa Brandner Prof. LLC | Dentist | 910 N Main Ave, Suite 101, Tea, SD 57064-0580 | 2015-01-09 |
| 1962939231 | Theresa Michelle Newcomb | Nurse Practitioner | Po Box 802, Tea, SD 57064-0802 | 2017-05-17 |
| 1710131107 | Jodi M Schnider | Speech-Language Pathologist | 200 W Charish St, Tea, SD 57064-2055 | 2008-11-11 |
| 1881772168 | Prairie Rehabilitation Services, Inc. | Durable Medical Equipment & Medical Supplies | 725 E Kevin Dr Ste 100, Tea, SD 57064-2070 | 2006-11-02 |
| 1356358030 | Nicholas Jon Shawd | Dentist | 725 E Kevin Dr, Suite 101, Tea, SD 57064-2070 | 2006-08-02 |
| Find all providers in zip 57064 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396343505 | Kaitlyn Mae Fritz | Family Medicine | Wellness Center 103, Brookings, SD 57007-0001 | 2020-10-12 |
| 1447877386 | Black Hills Primary Care PC | Family Medicine | 8075 Stage Stop Rd., Summerset, SD 57718 | 2020-06-26 |
| 1467003251 | Arthur Lampert | Family Medicine | 1770 Tablerock Rd Apt 120, Rapid City, SD 57701-5586 | 2019-09-24 |
| 1851883540 | Modern Day Health Care Prof LLC | Family Medicine | 125 Railroad Ave Se, Aberdeen, SD 57401-4202 | 2018-05-30 |
| 1427555002 | Sanford Clinic | Family Medicine | 136 S Phillips Ave Ste 102, Sioux Falls, SD 57104 | 2018-04-10 |
| 1023524741 | Quick Health Urgent Care LLC | Family Medicine | 7600 S Louise Ave Ste 150, Sioux Falls, SD 57108-5999 | 2017-12-18 |
| 1568991446 | Callie Pederson | Family Medicine | 28th Medical Group, 2900 Doolitle Drive, Ellsworth Afb, SD 57706-4821 | 2017-06-05 |
| 1144751256 | Maya Itza Koehler | Family Medicine | 534 Oregon Ave Se, Huron, SD 57350-2801 | 2017-03-22 |
| 1578004883 | Sacred Heart Health Services | Family Medicine | 2525 Fox Run Pkwy Ste 200, Yankton, SD 57078-5371 | 2017-03-20 |
| 1073992004 | Monument Health Network, Inc. | Family Medicine | 209 Ramsland St, Buffalo, SD 57720-0045 | 2015-05-22 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.