AVERA MEDICAL GROUP WINDOM – NPI #1851491690
Family Medicine

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.

Health Care Provider Taxonomy Code for Family Medicine

AVERA MEDICAL GROUP WINDOM is a provider located in WINDOM, MN. NPPES has assigned the NPI number 1851491690 to AVERA MEDICAL GROUP WINDOM on September 22, 2006. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “AVERA MEDICAL GROUP WINDOM” is a dba name, the actual legal business name for this organization is AVERA MCKENNAN. The primary taxonomy selected by this provider is 207Q00000X from the Health Care Provider Taxonomy code set, which is classified as Family Medicine.

The NPI profile was previously updated about 5 years ago on Jun 10, 2021. 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 MEDICAL GROUP WINDOM below.

NPI Profile for
AVERA MCKENNAN

NPI Number
1851491690
Enumeration Date

(more than 19 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 MEDICAL GROUP WINDOM
Primary location
2020 HOSPITAL DR., STE. 2
WINDOM, MN 56101-1766
Phone: (507) 831-1703 Fax: (507) 831-5668
Mailing address
800 E 21ST STREET
PO BOX5045
SIOUX FALLS, SD 57117-5045
Phone: (605) 322-6375 Fax: (605) 322-6363
Organization Subpart
Yes - AVERA MEDICAL GROUP WINDOM is subpart of another organization.
Authorized Official
DAVID FLICEK
PRESIDENT/CEO
Phone: (605) 322-7915
Updated
Certification Date
May 25, 2021

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 MEDICAL GROUP WINDOM

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
OTHERRAILROAD MEDICAREC18643
MEDICAIDMN433903700
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
207Q00000X
- Family Medicine (Primary)

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.