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AVERA MCKENNAN NPI 1407829781


NPI Information

NPI: 1407829781
Provider Name: AVERA MCKENNAN

Doing Business As: AVERA MEDICAL GROUP MIDWEST PSYCHIATRIC MEDICINE SIOUX FALLS

Classification: Psychiatry & Neurology - 2084P0800X
Entity Type: Organization

Specialization: Psychiatry

Address:
4400 W 69TH ST
STE 500
SIOUX FALLS, SD
ZIP 57108
Phone: (605) 322-7580
Get Directions

AVERA MCKENNAN is a psychiatry psychiatry neurology in Sioux Falls, SD. The provider is a Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems. AVERA MCKENNAN NPI is 1407829781. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Avera Medical Group Midwest Psychiatric Medicine Sioux Falls.

The provider's business location address is:

4400 W 69TH ST
STE 500
SIOUX FALLS, SD
ZIP 57108
Phone: (605) 322-7580
Fax: (605) 322-7579

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 2/8/2006 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
12084P0800XPsychiatry & NeurologyPsychiatryYes

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
20211607MEDICAIDIOWA
365742OTHERSOUTH DAKOTAHEALTHPARTNERS
40006118OTHERSOUTH DAKOTABCBS
592411422904OTHERSOUTH DAKOTAPRIMEWEST
6========= 13OTHERSOUTH DAKOTADAKOTACARE
7293011100MEDICAIDMINNESOTA
83T021SCOTHERMINNESOTABLUE 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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