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Contact Information

AVERA MCKENNAN
1417 S. CLIFF AVE.
STE. 100
SIOUX FALLS, SD57105-1063
 Phone: 605-322-8937
 Fax: 605-322-8938
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Maternal & Fetal Medicine

207VM0101X 16 Physician/Obstetrics & Gynecology
Indicates primary specialty

NPI Profile & details for AVERA MCKENNAN

NPI Number 1205808748
LBN Legal business name AVERA MCKENNAN
Authorized official RONALD PLACE - (CEO/PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 02/07/2006
Last updated 03/12/2026 - About 3 months ago
Identifiers
IA Medicaid 0573360
MN Medicaid 482413000
NE Medicaid 10025040700
MN Other 361ROPE BCBS
MN Other 361R1WA BLUE PLUS
SD Other 4994376 BCBS
SD Other 370624200 DEPT OF LABOR
SD Other 95736 HEALTHPARTNERS
SD Other 924114229808 PRIMEWEST
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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