AVERA MCKENNAN NPI 1558337899

NPI Information

NPI: 1558337899
Provider Name: AVERA MCKENNAN

Doing Business As: AVERA MEDICAL GROUP PEDIATRIC SPECIALISTS SIOUX FALLS

Classification: Pediatrics - 208000000X
Entity Type: Organization
Address:
1417 S. CLIFF AVE.
STE. 010
SIOUX FALLS, SD
ZIP 57105
Phone: (605) 322-3666
Get Directions

AVERA MCKENNAN is a pediatrics in Sioux Falls, SD. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. AVERA MCKENNAN NPI is 1558337899. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Avera Medical Group Pediatric Specialists Sioux Falls.

The provider's business location address is:

1417 S. CLIFF AVE.
STE. 010
SIOUX FALLS, SD
ZIP 57105-014
Phone: (605) 322-3666
Fax: (605) 322-3665

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 2/27/2006 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	208000000X	Pediatrics				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	200806800	MEDICAID	MINNESOTA
2	65740	OTHER	SOUTH DAKOTA	HEALTHPARTNERS
3	9169058	OTHER	SOUTH DAKOTA	DAKOTACARE
4	000080878	OTHER	MINNESOTA	PRIMEWEST
5	250R5PE	OTHER	MINNESOTA	BCBS WORTHINGTON
6	0006729	OTHER	SOUTH DAKOTA	BCBS
7	3D887KU	OTHER	MINNESOTA	BLUE PLUS
8	370624200	OTHER	SOUTH DAKOTA	DEPT OF LABOR
9	3D887KU	OTHER	MINNESOTA	BCBS
10	0248534	MEDICAID	IOWA
11	=========39	MEDICAID	NEBRASKA

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

NPI Synchronization or Removal

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