AVERA MCKENNAN – NPI #1104892892
Internal Medicine

An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation.

Health Care Provider Taxonomy Code for Internal Medicine

AVERA MCKENNAN is a provider located in SIOUX FALLS, SD. NPPES has assigned the NPI number 1104892892 to AVERA MCKENNAN on February 23, 2006. It is a Type-2 NPI, indicating this NPI number is associated with an organization. This provider is also associated with 2 additional names listed below. According to the NPI Registry, there are 2 additional location(s) assigned to this provider which are listed below. The primary taxonomy selected by this provider is 207RN0300X from the Health Care Provider Taxonomy code set, which is classified as Internal Medicine, specializing in Nephrology

The NPI profile was last updated on Mar 12, 2026. 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 MCKENNAN below.

NPI Profile for
AVERA MCKENNAN

NPI Number
1104892892
Enumeration Date

(more than 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
Other name(s)
All associated names:
Doing Business As (dba)
Avera Nephrology
Doing Business As (dba)
Avera Nephrology Sioux Falls
Primary location
810 E 23RD ST STE 403
SIOUX FALLS, SD 57105-2135
Phone: (605) 322-5800 Fax: (605) 322-5801
2 Other location(s):
1315 S. Cliff Ave.
Ste. 2000
Sioux Falls, SD 57105-1058
Phone: (605) 322-5800
Fax: (605) 322-5801
911 E 20th St Ste 509
Sioux Falls, SD 57105-1047
Phone: (605) 322-5800
Fax: (605) 322-5801
Mailing address
PO BOX 86370
SIOUX FALLS, SD 57118-6370
Phone: (605) 322-7510 Fax: (605) 322-6475
Organization Subpart
No
Authorized Official
RONALD PLACE
CEO/PRESIDENT
Phone: (605) 322-7903
Updated
Certification Date
Mar 12, 2026

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 MCKENNAN

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.

See identifiers
DescriptionIssuerStateIdentifier
otherBCBSMN118T5NO
otherBCBSSD0008493
otherBLUE PLUSMN118T5NO
otherDEPT OF LABORSD370624200
otherHEALTHPARTNERSSD81741
otherPRIMEWESTMN031013001
medicaidIA0550814
medicaidMN210830500
medicaidND12903
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
207RN0300X
- Internal Medicine / Nephrology (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.