AVERA MCKENNAN NPI 1730155425

NPI Information

NPI: 1730155425
Provider Name: AVERA MCKENNAN

Doing Business As: AVERA MEDICAL GROUP TRANSPLANT AND LIVER SURGERY SIOUX FALLS

Classification: Transplant Surgery - 204F00000X
Entity Type: Organization
Address:
1315 S. CLIFF AVE.
STE. 1100
SIOUX FALLS, SD
ZIP 57105
Phone: (605) 322-7350
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AVERA MCKENNAN is a transplant surgery in Sioux Falls, SD. The provider is a surgeon who specializes in transplant surgery. Source: National Uniform Claim Committee AVERA MCKENNAN NPI is 1730155425. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Avera Medical Group Transplant And Liver Surgery Sioux Falls.

The provider's business location address is:

1315 S. CLIFF AVE.
STE. 1100
SIOUX FALLS, SD
ZIP 57105-057
Phone: (605) 322-7350
Fax: (605) 322-7351

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 2/23/2006 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	204F00000X	Transplant Surgery				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	0040030	OTHER	SOUTH DAKOTA	BCBS
2	90287	OTHER	SOUTH DAKOTA	HP
3	=========46	MEDICAID	NEBRASKA
4	073278800	MEDICAID	MINNESOTA
5	0572438	MEDICAID	IOWA
6	370624200	OTHER	SOUTH DAKOTA	DEPT OF LABOR
7	50M72VA	OTHER	MINNESOTA	BCBS
8	9202242	OTHER	SOUTH DAKOTA	DAKOTACARE

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: 5/5/2024

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