AVERA MCKENNAN NPI 1871527507

NPI Information

  • NPI: 1871527507
  • Provider Name: AVERA MCKENNAN
  • Classification: Clinic/Center - 261QP2300X
  • Specialization: Primary Care
  • Entity Type: Organization
  • Doing Business As: AVERA MEDICAL GROUP LARCHWOOD
  • CLIA Number: 16D0901662
  • Address: 916 HOLDER ST
    LARCHWOOD, IA
    ZIP 51241
  • Phone: (712) 477-2185

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NPI Details

AVERA MCKENNAN is a primary care clinic center in Larchwood, IA. AVERA MCKENNAN NPI is 1871527507. The provider is registered as an organization entity type.
The provider Is Doing Business As Avera Medical Group Larchwood.

The provider's business location address is:

916 HOLDER ST
LARCHWOOD, IA
ZIP 51241-008
Phone: (712) 477-2185
Fax: (712) 477-2186

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 16D0901662 - physician office with a certificate type of Certificate of Accreditation.

The enumeration date for this NPI number is 7/10/2006 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
1261QP2300XClinic/CenterPrimary CareYes

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
119986MEDICARE ID-TYPE UNSPECIFIEDIOWA
22900993MEDICAIDIOWA
30425074MEDICAIDIOWA

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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