# AVERA MCKENNAN

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** Avera Therapy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1629499132
- **Authorized official:** RONALD JOSEPH PLACE MD (PRESIDENT/CEO)
- **Authorized official phone:** (605) 322-7903

## Contact information

- **Practice address:** 6100 S LOUISE AVE STE 1275, SIOUX FALLS, SD 57108-6029
- **Practice address phone:** (605) 322-8000
- **Mailing address:** PO BOX 5045, ATTN: P.F.S. PROV ENROLLMT, SIOUX FALLS, SD 57117-5045
- **Mailing address phone:** (605) 322-3278
- **Mailing address fax:** (605) 322-5191

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | — | NULL | Yes |
| 225100000X | Physical Therapist | — | — | Yes |
| 225X00000X | Occupational Therapist | — | NULL | — |
| 225X00000X | Occupational Therapist | — | — | — |
| 235Z00000X | Speech-Language Pathologist | — | NULL | — |
| 235Z00000X | Speech-Language Pathologist | — | — | — |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | — |
| 335E00000X | Prosthetic/Orthotic Supplier | — | NULL | — |

## Other

- **Enumeration date:** 12/31/2013
- **Last updated:** 11/13/2024