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AVERA MCKENNAN NPI 1114113693


NPI Information

NPI: 1114113693
Provider Name: AVERA MCKENNAN

Doing Business As: AVERA MEDICAL GROUP BRAIN AND SPINE INSTITUTE

Classification: Neurological Surgery - 207T00000X
Entity Type: Organization
Address:
1301 S. CLIFF AVE.
SIOUX FALLS, SD
ZIP 57105
Phone: (605) 322-8860
Get Directions

AVERA MCKENNAN is a neurological surgery in Sioux Falls, SD. The provider is a neurological surgeon provides the operative and non-operative management (i.e., prevention, diagnosis, evaluation, treatment, critical care, and rehabilitation) of disorders of the central, peripheral, and autonomic nervous systems, including their supporting structures and vascular supply; the evaluation and treatment of pathological processes which modify function or activity of the nervous system; and the operative and non-operative management of pain. A neurological surgeon treats patients with disorders of the nervous system; disorders of the brain, meninges, skull, and their blood supply, including the extracranial carotid and vertebral arteries; disorders of the pituitary gland; disorders of the spinal cord, meninges, and vertebral column, including those which may require treatment by spinal fusion or instrumentation; and disorders of the cranial and spinal nerves throughout their distribution. AVERA MCKENNAN NPI is 1114113693. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Avera Medical Group Brain And Spine Institute.

The provider's business location address is:

1301 S. CLIFF AVE.
SIOUX FALLS, SD
ZIP 57105-032
Phone: (605) 322-8860
Fax: (605) 322-8868

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 9/19/2007 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
1207T00000XNeurological SurgeryYes

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
14992512OTHERSOUTH DAKOTABLUE CROSS/SOUTH DAKOTA
246L90AVOTHERMINNESOTABLUE PLUS
3167009OTHERSOUTH DAKOTAHEALTHPARTNERS
49251037OTHERSOUTH DAKOTADAKOTACARE

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

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