AVERA MCKENNAN NPI 1063432573

NPI Information

  • NPI: 1063432573
  • Provider Name: AVERA MCKENNAN
  • Classification: Physician Assistant - 363A00000X
  • Entity Type: Organization
  • Doing Business As: AVERA MEDICAL GROUP VOLGA
  • Address: 210 KASAN AVE
    VOLGA, SD
    ZIP 57071
  • Phone: (605) 627-5701

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NPI Details

AVERA MCKENNAN is a physician assistant in Volga, SD. The provider is a physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. AVERA MCKENNAN NPI is 1063432573. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Avera Medical Group Volga.

The provider's business location address is:

210 KASAN AVE
VOLGA, SD
ZIP 57071
Phone: (605) 627-5701
Fax: (605) 627-5990

The provider's authorized official is Julie N. Norton .
The authorized official title is Cfo and has the following contact phone number (605) 322-6375.

The enumeration date for this NPI number is 7/20/2006 and was last updated on 3/11/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363A00000XPhysician Assistant84SOUTH DAKOTAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
17300750MEDICAIDSOUTH DAKOTA
2433835MEDICARE OSCAR/CERTIFICATIONSOUTH DAKOTA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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