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AVERA MCKENNAN NPI 1629052451


NPI Information

NPI: 1629052451
Provider Name: AVERA MCKENNAN

Doing Business As: AVERA LEE MABEE OB/GYN

Classification: Obstetrics & Gynecology - 207V00000X
Entity Type: Organization
Address:
1910 W 69TH ST
SUITE 100
SIOUX FALLS, SD
ZIP 57108
Phone: (605) 322-5260
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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 1629052451. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Avera Lee Mabee Ob/gyn.

The provider's business location address is:

1910 W 69TH ST
SUITE 100
SIOUX FALLS, SD
ZIP 57108-612
Phone: (605) 322-5260
Fax: (605) 322-5265

The provider's authorized official is Julie Norton .
The authorized official title is Cfo/svp and has the following contact phone number (605) 322-7818.

The enumeration date for this NPI number is 12/5/2005 and was last updated on 5/31/2017.


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
1207V00000XObstetrics & Gynecology2481SOUTH 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
1D25442MEDICARE UPIN
20009398OTHERWALLMARK
3S 100716MEDICARE PINSOUTH DAKOTA
46200390MEDICAIDSOUTH DAKOTA
522232OTHERSIOUX VALLEY HEALTH PLAN
6228834OTHERMIDLANDS CHOICE

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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