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AVERA MCKENNAN NPI 1538135447


NPI Information

NPI: 1538135447
Provider Name: AVERA MCKENNAN

Doing Business As: AVERA MEDICAL GROUP HEMATOLOGY, TRANSPLANT & CELLULAR THERAPY SIOUX FA

Classification: Internal Medicine - 207RH0003X
Entity Type: Organization

Specialization: Hematology & Oncology

Address:
1000 E. 23RD ST.
STE. 200
SIOUX FALLS, SD
ZIP 57105
Phone: (605) 322-3035
Get Directions

AVERA MCKENNAN is a hematology and oncology internal medicine in Sioux Falls, SD. The provider is an internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. AVERA MCKENNAN NPI is 1538135447. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Avera Medical Group Hematology, Transplant & Cellular Therapy Sioux Fa.

The provider's business location address is:

1000 E. 23RD ST.
STE. 200
SIOUX FALLS, SD
ZIP 57105-122
Phone: (605) 322-3035
Fax: (605) 322-3036

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 2/28/2006 and was last updated on 1/18/2021.


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
1207RH0003XInternal MedicineHematology & OncologyYes

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
10007442OTHERSOUTH DAKOTABCBS
29174731OTHERSOUTH DAKOTADAKOTACARE
368B91LEOTHERMINNESOTABCBS
492411422911OTHERMINNESOTAPRIMEWEST
5306918400MEDICAIDMINNESOTA
6370624200OTHERSOUTH DAKOTADEPT OF LABOR
768B91LEOTHERMINNESOTABLUE PLUS
871664OTHERSOUTH DAKOTAHEALTHPARTNERS
90573931MEDICAIDIOWA

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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