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AVERA MCKENNAN NPI 1073585949


NPI Information

NPI: 1073585949
Provider Name: AVERA MCKENNAN

Other Name: AVERA MEDICAL GROUP NEONATOLOGY SIOUX FALLS

Classification: Pediatrics - 2080N0001X
Entity Type: Organization

Specialization: Neonatal-Perinatal Medicine

Address:
1325 S. CLIFF AVE.
SIOUX FALLS, SD
ZIP 57105
Phone: (605) 322-4425
Get Directions

AVERA MCKENNAN is a neonatal-perinatal medicine pediatrics in Sioux Falls, SD. The provider is a pediatrician who is the principal care provider for sick newborn infants. Clinical expertise is used for direct patient care and for consulting with obstetrical colleagues to plan for the care of mothers who have high-risk pregnancies. AVERA MCKENNAN NPI is 1073585949. The provider is registered as an organization entity type and is a single specialty group.
The provider Other Name Is Avera Medical Group Neonatology Sioux Falls.

The provider's business location address is:

1325 S. CLIFF AVE.
SIOUX FALLS, SD
ZIP 57105-007
Phone: (605) 322-4425
Fax: (605) 322-4499

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 2/6/2006 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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
12080N0001XPediatricsNeonatal-Perinatal MedicineYes

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
1370624200OTHERSOUTH DAKOTADEPT OF LABOR
27F824MAOTHERMINNESOTABLUE PLUS
36701340MEDICAIDSOUTH DAKOTA
46701500MEDICAIDSOUTH DAKOTA
561598OTHERSOUTH DAKOTAHEALTHPARTNERS
66701090MEDICAIDSOUTH DAKOTA
74999723OTHERSOUTH DAKOTABCBS
80555367MEDICAIDIOWA
9=========45MEDICAIDNEBRASKA
10=========7OTHERSOUTH DAKOTADAKOTACARE
11065778600MEDICAIDMINNESOTA
126701790MEDICAIDSOUTH DAKOTA

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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