AVERA GREGORY DIALYSIS UNIT – NPI #1255435814
Clinic/Center

AVERA GREGORY DIALYSIS UNIT is an AHC clinic located in GREGORY, SD. NPPES has assigned the NPI number 1255435814 to AVERA GREGORY DIALYSIS UNIT on September 12, 2006. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “AVERA GREGORY DIALYSIS UNIT” is a dba name, the actual legal business name for this organization is AVERA MCKENNAN. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 261QE0700X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in End-Stage Renal Disease (ESRD) Treatment

The NPI profile was previously updated about 3 years ago on Oct 04, 2023. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for AVERA GREGORY DIALYSIS UNIT below.

NPI Profile for
AVERA MCKENNAN

NPI Number
1255435814
Enumeration Date

(about 20 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
AVERA MCKENNAN
Doing Business As (dba): AVERA GREGORY DIALYSIS UNIT
Primary location
110 S LOGAN AVE
GREGORY, SD 57533-1614
Phone: (605) 835-8394 Fax:
1 Other location(s):
400 Park Ave.
Gregory, SD 57533-0408
Phone: (605) 835-8394 Ext: 183
Fax: (605) 835-9422
Mailing address
PO BOX 408
400 PARK AVE.
GREGORY, SD 57533-0408
Phone: (605) 835-8394 Fax: (605) 835-9422
Organization Subpart
No
Authorized Official
RONALD PLACE
CEO/PRESIDENT
Phone: (605) 322-7903
Updated
Certification Date
Oct 04, 2023

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Identifiers

Identifiers for AVERA GREGORY DIALYSIS UNIT

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
medicaidSD5500350
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QE0700X
- Clinic/Center / End-Stage Renal Disease (ESRD) Treatment (Primary)
282NC0060X
- General Acute Care Hospital / Critical Access
SD 54875

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.