AVERA MCKENNAN NPI 1386610004

NPI Information

NPI: 1386610004
Provider Name: AVERA MCKENNAN

Doing Business As: AVERA MEDICAL GROUP PULMONARY AND SLEEP MEDICINE SIOUX FALLS

Classification: Internal Medicine - 207RP1001X
Entity Type: Organization

Specialization: Pulmonary Disease

Address:
1301 S. CLIFF AVE.
STE. 601
SIOUX FALLS, SD
ZIP 57105
Phone: (605) 322-6930
Get Directions

AVERA MCKENNAN is a pulmonary disease internal medicine in Sioux Falls, SD. The provider is an internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs. AVERA MCKENNAN NPI is 1386610004. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Avera Medical Group Pulmonary And Sleep Medicine Sioux Falls.

The provider's business location address is:

1301 S. CLIFF AVE.
STE. 601
SIOUX FALLS, SD
ZIP 57105-032
Phone: (605) 322-6930
Fax: (605) 322-6931

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 2/23/2006 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	207RP1001X	Internal Medicine	Pulmonary Disease			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	0040252	OTHER	SOUTH DAKOTA	BCBS SD
2	92411422905	OTHER	MINNESOTA	PRIME WEST
3	=========7	MEDICAID	NEBRASKA
4	286T1PU	OTHER	MINNESOTA	BCBS MN
5	0555169	MEDICAID	IOWA
6	370624200	OTHER	SOUTH DAKOTA	DEPT OF LABOR
7	84208	OTHER	SOUTH DAKOTA	HEALTHPARTNERS
8	984617400	MEDICAID	MINNESOTA
9	286T1PU	OTHER	MINNESOTA	BLUE PLUS
10	9202238	OTHER	SOUTH DAKOTA	DAKOTACARE

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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