AVERA MCKENNAN NPI 1174671242

NPI Information

  • NPI: 1174671242
  • Provider Name: AVERA MCKENNAN
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Organization
  • Doing Business As: AVERA MEDICAL GROUP GARRETSON
  • CLIA Number: 43D0406845
  • Address: 980 4TH STREET
    GARRETSON, SD
    ZIP 57030
  • Phone: (605) 594-3431

Map and Directions

Get Directions

NPI Details

AVERA MCKENNAN is a family medicine in Garretson, SD. The provider is 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. AVERA MCKENNAN NPI is 1174671242. The provider is registered as an organization entity type and is a multiple single specialty group.
The provider Is Doing Business As Avera Medical Group Garretson.

The provider's business location address is:

980 4TH STREET
GARRETSON, SD
ZIP 57030-250
Phone: (605) 594-3431

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

The CLIA number assigned to this NPI record is 43D0406845 - community clinic with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/8/2007 and was last updated on 3/21/2011.

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
1207Q00000XFamily Medicine4884SOUTH DAKOTANo
2207Q00000XFamily Medicine5054SOUTH DAKOTANo
3207Q00000XFamily Medicine5214SOUTH DAKOTANo
4207Q00000XFamily Medicine3579SOUTH 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
18142MEDICARE ID-TYPE UNSPECIFIEDSOUTH DAKOTA
25609088MEDICAIDSOUTH DAKOTA
35611292MEDICAIDSOUTH DAKOTA
4E72988MEDICARE UPINSOUTH DAKOTA
5H70197MEDICARE UPINSOUTH DAKOTA
65611473MEDICAIDSOUTH DAKOTA
7H46420MEDICARE UPINSOUTH DAKOTA
83421MEDICARE ID-TYPE UNSPECIFIEDSOUTH DAKOTA
941363MEDICARE ID-TYPE UNSPECIFIEDSOUTH DAKOTA
1040598MEDICARE ID-TYPE UNSPECIFIEDSOUTH DAKOTA
115610962MEDICAIDSOUTH DAKOTA
12H48435MEDICARE UPINSOUTH 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

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

Previous NPI
Next NPI