AVERA MCKENNAN NPI 1053680678

NPI Information

NPI: 1053680678
Provider Name: AVERA MCKENNAN

Doing Business As: AVERA MEDICAL GROUP RADIOLOGY SIOUX FALLS

Classification: Radiology - 2085R0202X
Entity Type: Organization

Specialization: Diagnostic Radiology

Address:
1325 S. CLIFF AVE.
SIOUX FALLS, SD
ZIP 57105
Phone: (605) 322-1600
Get Directions

AVERA MCKENNAN is a diagnostic radiology radiology in Sioux Falls, SD. The provider is a radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. AVERA MCKENNAN NPI is 1053680678. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Avera Medical Group Radiology Sioux Falls.

The provider's business location address is:

1325 S. CLIFF AVE.
SIOUX FALLS, SD
ZIP 57105-007
Phone: (605) 322-1600

The provider's authorized official is David Flicek .
The authorized official title is Ceo/president and has the following contact phone number (605) 322-8000.

The enumeration date for this NPI number is 12/28/2011 and was last updated on 10/24/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2085R0202X	Radiology	Diagnostic Radiology			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	CE0909	OTHER	SOUTH DAKOTA	RAILROAD MEDICARE
2	CG9797	OTHER	SOUTH DAKOTA	RAILROAD MEDICARE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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