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AVERA MCKENNAN NPI 1649461369


NPI Information

NPI: 1649461369
Provider Name: AVERA MCKENNAN

Doing Business As: AVERA NEUROSURGERY - DANIEL G. TYNAN, M.D.

Classification: Neurological Surgery - 207T00000X
Entity Type: Organization
Address:
1100 E 21ST ST
STE 600
SIOUX FALLS, SD
ZIP 57105
Phone: (605) 322-4800
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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 1649461369. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Avera Neurosurgery - Daniel G. Tynan, M.d..

The provider's business location address is:

1100 E 21ST ST
STE 600
SIOUX FALLS, SD
ZIP 57105-020
Phone: (605) 322-4800
Fax: (605) 322-4801

The provider's authorized official is Julie N Norton .
The authorized official title is Senior Vp Of Finance and has the following contact phone number (605) 322-6375.

The enumeration date for this NPI number is 8/7/2007 and was last updated on 3/30/2010.


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 Surgery4653SOUTH DAKOTAYes

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
19251035OTHERSOUTH DAKOTADAKOTACARE
2F29008MEDICARE UPINSOUTH DAKOTA
310025595900MEDICAIDNEBRASKA
4S102122MEDICARE PINSOUTH DAKOTA
54992604OTHERSOUTH DAKOTABLUE CROSS/SD
66I362AVOTHERMINNESOTABLUE PLUS

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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