Avera Mckennan
Avera Mckennan is a healthcare organization registered as Rural Health Clinic/Center in Wilmot, SD, holding Type 2 (organization) NPI 1770680787 since 2006. The authorized official on file is David Flicek, President/Ceo.
✓ Active NPI ✓ Valid NPI checksum
| NPI | 1770680787 |
|---|---|
| Entity type | Organization (Type 2) |
| Legal business name | Avera Mckennan |
| Other name | <Unavail> |
| Practice address | 409 4TH ST, Wilmot, SD, 57279 |
| Phone | 6059384351 |
| Fax | 6059384351 |
| Enumeration date | 2006-09-20 |
| Last updated in NPPES | 2020-09-10 |
Authorized official
| Name | David Flicek |
|---|---|
| Title | President/Ceo |
| Phone | 6053227916 |
Taxonomy & classification
| Taxonomy code | Specialty | Primary | License | State |
|---|---|---|---|---|
| 363L00000X | Nurse Practitioner | Secondary | — | — |
| 261QR1300X | Rural Health Clinic/Center | Primary | — | — |
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5300010 | Medicaid | SD | — |
| 43D0901649 | Other | SD | CLIA # |
Copy-ready billing details
Provider: Avera Mckennan NPI: 1770680787 Taxonomy: 261QR1300X (Rural Health Clinic/Center) Address: 409 4TH ST, Wilmot, SD, 57279
Providers at this address
| NPI | Name | Type | Specialty | Location |
|---|---|---|---|---|
| 1447215207 | Susan Leddy | Individual | Nurse Practitioner | Wilmot, SD |
| 1710033220 | Coteau Des Prairies Hospital, Inc. | Organization | Rural Health Clinic/Center | Wilmot, SD |
| 1700925153 | Coteau Des Prairies Hospital, Inc | Organization | Clinic/Center | Wilmot, SD |
Verify this record
Cross-check NPI 1770680787 against the authoritative CMS record: view Avera Mckennan on the official NPPES registry .
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes — even if the provider moves or changes specialty. Read the full guide or validate an NPI number.
Frequently asked questions
What type of organization is Avera Mckennan?
What is a Type 2 NPI?
Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2020-09-10.