AVERA MCKENNAN NPI 1336111962

NPI Information

NPI: 1336111962
Provider Name: AVERA MCKENNAN

Doing Business As: AVERA MEDICAL GROUP WOMENS HEALTH SPECIALISTS SIOUX FALLS

Classification: Obstetrics & Gynecology - 207V00000X
Entity Type: Organization
Address:
1417 S. CLIFF AVE.
STE. 401
SIOUX FALLS, SD
ZIP 57105
Phone: (605) 322-8920
Get Directions

AVERA MCKENNAN is an obstetrics gynecology in Sioux Falls, SD. The provider is an obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. AVERA MCKENNAN NPI is 1336111962. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Avera Medical Group Womens Health Specialists Sioux Falls.

The provider's business location address is:

1417 S. CLIFF AVE.
STE. 401
SIOUX FALLS, SD
ZIP 57105-064
Phone: (605) 322-8920
Fax: (605) 322-8919

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 2/7/2006 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	207V00000X	Obstetrics & Gynecology				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	0007994	OTHER	SOUTH DAKOTA	BCBS
2	33582	OTHER	IOWA	BC/IA
3	33583	OTHER	IOWA	BC/IA
4	48D59OB	OTHER	MINNESOTA	BCBS
5	77716	OTHER	SOUTH DAKOTA	HEALTHPARTNERS
6	9177835	OTHER	SOUTH DAKOTA	DAKOTACARE
7	33581	OTHER	IOWA	BC/IA
8	=========16	MEDICAID	NEBRASKA
9	48D59OB	OTHER	MINNESOTA	BLUE PLUS
10	04235	OTHER	IOWA	BC/IA
11	370624200	OTHER	SOUTH DAKOTA	DEPT OF LABOR
12	70000	OTHER	IOWA	BC/IA
13	040115001	OTHER	SOUTH DAKOTA	PRIMEWEST
14	0548537	MEDICAID	IOWA
15	194898900	MEDICAID	MINNESOTA

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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