AVERA MCKENNAN NPI 1184690943

NPI Information

  • NPI: 1184690943
  • Provider Name: AVERA MCKENNAN
  • Classification: Clinic/Center - 261Q00000X
  • Entity Type: Organization
  • Doing Business As: AVERA MEDICAL GROUP HARRISBURG
  • CLIA Number: 43D1045574
  • Address: 220 S CLIFF AVE STE 120
    HARRISBURG, SD
    ZIP 57032
  • Phone: (605) 213-8000

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NPI Details

AVERA MCKENNAN is a clinic center in Harrisburg, SD. The provider is a facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). AVERA MCKENNAN NPI is 1184690943. The provider is registered as an organization entity type.
The provider Is Doing Business As Avera Medical Group Harrisburg.

The provider's business location address is:

220 S CLIFF AVE STE 120
HARRISBURG, SD
ZIP 57032-117
Phone: (605) 213-8000
Fax: (605) 213-8005

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

The CLIA number assigned to this NPI record is 43D1045574 - physician office with a certificate type of Certificate of Accreditation.

The enumeration date for this NPI number is 2/23/2006 and was last updated on 5/16/2012.

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
1261Q00000XClinic/CenterYes

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
11202730019MEDICARE NSC
2100816MEDICARE ID-TYPE UNSPECIFIEDSOUTH 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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