AVERA MCKENNAN NPI 1083859532

NPI Information

NPI: 1083859532
Provider Name: AVERA MCKENNAN

Doing Business As: AVERA MEDICAL GROUP SURGERY PIERRE

Classification: Clinic/Center - 261QA1903X
Entity Type: Organization

Specialization: Ambulatory Surgical

Address:
100 MAC LN
PIERRE, SD
ZIP 57501
Phone: (605) 224-5901
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AVERA MCKENNAN is an ambulatory surgical clinic center in Pierre, SD. AVERA MCKENNAN NPI is 1083859532. The provider is registered as an organization entity type.
The provider Is Doing Business As Avera Medical Group Surgery Pierre.

The provider's business location address is:

100 MAC LN
PIERRE, SD
ZIP 57501-391
Phone: (605) 224-5901
Fax: (605) 945-3244

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

The enumeration date for this NPI number is 12/12/2008 and was last updated on 4/29/2011.

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
1	261QA1903X	Clinic/Center	Ambulatory Surgical	11146	SOUTH DAKOTA	Yes

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
1	DO6835	OTHER	SOUTH DAKOTA	RR MEDICARE
2	1202730026	MEDICARE NSC	SOUTH 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: 4/28/2024

NPI Synchronization or Removal

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