AVERA MEDICAL GROUP FAIRFAX
NPI 1215967203
Clinic/Center in Fairfax, SD
NPI Status: Active since July 04, 2006
Contact Information
421 MAIN ST
FAIRFAX, SD
ZIP 57335
Phone: (605) 654-2366
- Organization
- Clinic/Center
- Accepts Insurance
- CLIA Number: 43D0047742
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 08-31-2026
About AVERA MEDICAL GROUP FAIRFAX
This page provides the complete NPI Profile along with additional information for Avera Medical Group Fairfax, a provider established in Fairfax, South Dakota operating as a Clinic/center. The healthcare provider is registered in the NPI registry with number 1215967203 assigned on July 2006. The practitioner's primary taxonomy code is 261Q00000X. The provider is registered as an organization and their NPI record was last updated 15 years ago. The provider's is doing business as Avera Medical Group Fairfax. The authorized official of this NPI record is Julie N Norton (Vice President Of Finance)
- NPI
- 1215967203
- Provider Legal Name
- AVERA MCKENNAN
- Other Organization Name
- AVERA MEDICAL GROUP FAIRFAX
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 421 MAIN ST FAIRFAX, SD 57335
- Location Phone
- (605) 654-2366
- Mailing Address
- PO BOX 354 421 MAIN FAIRFAX, SD 57335
- Mailing Phone
- (605) 654-2366
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 07-04-2006
- Last Update Date
- 03-21-2011
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Clinic/Center
- Taxonomy Code
- 261Q00000X
- Type
- Ambulatory Health Care Facilities
- Taxonomy Description
- A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- ConnectPlus $0 Gold - PPO
- ConnectPlus $0 Silver - PPO
- ConnectPlus $10,600 HSA Eligible HDHP - PPO
- ConnectPlus $1800 - PPO
- ConnectPlus $4500 - PPO
- ConnectPlus $6500 HSA Eligible HDHP - PPO
- ConnectPlus $7500 HSA Eligible HDHP - PPO
- ConnectPlus MyWeighForward $2000 - PPO
- ConnectPlus MyWeighForward $6000 - PPO
- ConnectPlus Standard $2000 - PPO
- Medica Individual Choice Bronze $0 Copay PCP Visits - HMO
- Medica Individual Choice Bronze Share - HMO
- Medica Individual Choice Expanded Bronze Standard - HMO
- Medica Individual Choice Gold $0 Copay PCP Visits - HMO
- Medica Individual Choice Gold Share - HMO
- Medica Individual Choice Gold Standard - HMO
- Medica Individual Choice Silver $0 Copay PCP Visits - HMO
- Medica Individual Choice Silver Share - HMO
- Medica Individual Choice Silver Standard - HMO
- Medica Insure Bronze $0 Copay PCP Visits - EPO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 28 | MEDICARE ID-TYPE UNSPECIFIED (04) | SD | |
| =========12 | MEDICAID (05) | NE | |
| CD8978 | MEDICARE PIN (08) | ||
| 0000028 | OTHER (01) | SD | WELLMARK BC/BS |
| S28 | MEDICARE PIN (08) | SD |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 43D0047742
- Facility Type
- Physician Office
- Certificate Effective Date
- September 01, 2024
- Certificate Expiration Date
- August 31, 2026
- Laboratory Director
- RICHARD G. KAFKA
- Certificate Type
- Certificate for Provider-Performed Microscopy Procedures (PPMP)
- Certificate Type Description
- This CLIA certificate is issued to Avera Medical Group Fairfax in which a physician, midlevel practitioner or dentist that performs specific microscopy procedures during the course of a patient's visit. A limited list of provider-performed microscopy procedures is included under this certificate type, which are categorized as moderate complexity testing.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1215967203, we treat the final digit (3) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 57. The final step is to find the difference between that total and the next multiple of ten (60 - 57 = 3).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 57 is 60. The difference is the calculated check digit.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1215967203, enumerated as an "organization" on July 04, 2006.
The provider is located at 421 MAIN ST FAIRFAX, SD 57335 and the phone number is (605) 654-2366.
Clinic/Center with taxonomy code 261Q00000X.
The provider might be accepting Accepts: Avera Health Plans, Medica, Medicare, Medicaid,. Please consult your insurance carrier or call the provider to verify.
