AVERA MCKENNAN NPI 1306939806

NPI Information

  • NPI: 1306939806
  • Provider Name: AVERA MCKENNAN
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Organization
  • Former Legal Business Name: AVERA MCKENNAN DBA AVERA WORTHINGTON SPECIALTY CLINICS
  • Address: 1216 RYANS RD
    SUITE 1
    WORTHINGTON, MN
    ZIP 56187
  • Phone: (507) 372-2921

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NPI Details

AVERA MCKENNAN is a family medicine in Worthington, MN. 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 1306939806. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Former Legal Business Name Is Avera Mckennan Dba Avera Worthington Specialty Clinics.

The provider's business location address is:

1216 RYANS RD
SUITE 1
WORTHINGTON, MN
ZIP 56187-722
Phone: (507) 372-2921
Fax: (507) 372-5789

The provider's authorized official is Julie N Norton .
The authorized official title is Cfo/svp and has the following contact phone number (605) 322-7818.

The enumeration date for this NPI number is 10/2/2006 and was last updated on 5/31/2017.

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
1103T00000XPsychologistNo
2207R00000XInternal MedicineNo
3207V00000XObstetrics & GynecologyNo
4208000000XPediatricsNo
5208600000XSurgeryNo
6363LP0808XNurse PractitionerPsychiatric/Mental HealthNo
7207Q00000XFamily MedicineYes

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
1951015000MEDICAIDMINNESOTA
21202730005MEDICARE NSCMINNESOTA

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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