AVERA MCKENNAN NPI 1902886567

NPI Information

  • NPI: 1902886567
  • Provider Name: AVERA MCKENNAN
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Organization
  • Doing Business As: AVERA MEDICAL GROUP SPENCER
  • CLIA Number: 16D0385496
  • Address: 116 E 11TH ST
    SUITE 101
    SPENCER, IA
    ZIP 51301
  • Phone: (712) 264-3500

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NPI Details

AVERA MCKENNAN is a family medicine in Spencer, IA. 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 1902886567. 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 Spencer.

The provider's business location address is:

116 E 11TH ST
SUITE 101
SPENCER, IA
ZIP 51301-364
Phone: (712) 264-3500
Fax: (712) 264-3535

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

The CLIA number assigned to this NPI record is 16D0385496 - physician office with a certificate type of Certificate of Accreditation.

The enumeration date for this NPI number is 1/19/2006 and was last updated on 3/12/2012.

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
1363A00000XPhysician AssistantIOWANo
2363LF0000XNurse PractitionerFamilyIOWANo
3363LP0200XNurse PractitionerPediatricsIOWANo
4207Q00000XFamily MedicineIOWAYes

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
10252791MEDICAIDIOWA
2I5491MEDICARE ID-TYPE UNSPECIFIEDIOWAGROUP MEDICARE PROVIDER
31202730014MEDICARE NSCIOWA

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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