MEDICARE: AVERA MCKENNAN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	207R00000X	Internal Medicine Physician
2	363A00000X	Physician Assistant
3	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1710107685
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AVERA MCKENNAN

Provider Business Mailing Address
First Line	:	PO BOX 86430
Second Line	:
City	:	SIOUX FALLS
State	:	SD
Zip	:	57118-6430
Country	:	US
Telephone Number	:	605-322-4900
Fax Number	:	605-322-4910

Provider Business Practice Location Address
First Line	:	740 S HILL ST
Second Line	:
City	:	SALEM
State	:	SD
Zip	:	57058-8760
Country	:	US
Telephone Number	:	605-425-2855
Fax Number	:	605-425-2149

Authorized Official
Title or Position	:	SR VICE PRESIDENT OF FINANCE
Name	:	JULIE N NORTON
Credential	:
Telephone Number	:	605-322-7818

Provider Enumeration Date	:	04/26/2007
Last Update Date	:	05/10/2012

Similar Medicare Providers

1992775027 — MS. JONI WAGNER PA-C
Practice Location Address:

740 S HILL ST
SALEM, SD
57058-8760

Practice Phone: 605-425-2855
Practice Fax: 605-425-2149

1952339343 — JOHN BARNETT PA-C
Practice Location Address:

740 S HILL ST
SALEM, SD
57058-8760

Practice Phone: 605-425-2855
Practice Fax:

1720608417 — ALEESHA MARIE DEKNIKKER CNP
Practice Location Address:

740 S HILL ST
SALEM, SD
57058-8760

Practice Phone: 605-425-2855
Practice Fax: 605-425-2149

1790468627 — ASHLEE HALL
Practice Location Address:

8760 SALEM CEMETERY RD
DE GRAFF, OH
43318-9560

Practice Phone: 937-407-7399
Practice Fax:

1639174568 — AVERA QUEEN OF PEACE
Practice Location Address:

741 S HILL ST
SALEM, SD
57058-8761

Practice Phone: 605-425-3038
Practice Fax: 605-425-3039

1467438960 — MR. WILLIAM J ROTH
Practice Location Address:

300 N MAIN ST
SALEM, SD
57058

Practice Phone: 605-425-2827
Practice Fax: 605-425-2052

Directions to “AVERA MCKENNAN ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.