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AVERA MCKENNAN NPI 1083894067


NPI Information

NPI: 1083894067
Provider Name: AVERA MCKENNAN

Doing Business As: AVERA MEDICAL GROUP HEALTH CARE CLINIC SIOUX FALLS

Classification: Internal Medicine - 207R00000X
Entity Type: Organization

CLIA Number: 43D0719165

Address:
300 N DAKOTA AVE.
STE. 117
SIOUX FALLS, SD
ZIP 57104
Phone: (605) 322-6800
Get Directions

AVERA MCKENNAN is an internal medicine in Sioux Falls, SD. The provider is a physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. AVERA MCKENNAN NPI is 1083894067. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Avera Medical Group Health Care Clinic Sioux Falls.

The provider's business location address is:

300 N DAKOTA AVE.
STE. 117
SIOUX FALLS, SD
ZIP 57104-020
Phone: (605) 322-6800
Fax: (605) 322-6802

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 CLIA number assigned to this NPI record is 43D0719165 - community clinic with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 11/7/2007 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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207R00000XInternal MedicineYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
130B74GUOTHERMINNESOTABLUE CROSS
257105F001OTHERSOUTH DAKOTATRICARE
30532341MEDICAIDIOWA
4=========35MEDICAIDSOUTH DAKOTA
50006020OTHERSOUTH DAKOTABLUE CROSS OF SOUTH DAKOT
6068417100MEDICAIDMINNESOTA
730B74GUOTHERSOUTH DAKOTABLUE PLUS
859767OTHERSOUTH DAKOTAHEALTHPARTNERS
99251873OTHERSOUTH DAKOTADAKOTACARE
1012262MEDICAIDNORTH DAKOTA

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: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.