AVERA MCKENNAN (NPI# 1033185582) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033185582 |
| Entity Type | Organization |
| Organization Name | AVERA MCKENNAN |
| Other Organization Name | AVERA MEDICAL GROUP ONCOLOGY AND HEMATOLOGY SIOUX FALLS |
| Practice Address |
1000 E. 23rd St. Ste. 230 Sioux Falls SD 57105-2122 |
| Mailing Address |
Po Box 86370 Sioux Falls SD 57118-6370 |
| Practice Telephone | 6053226900 |
| Practice Fax Number | 6053226901 |
| Mailing Telephone | 6053227510 |
| Mailing Fax Number | 6053226475 |
| Enumeration Date | 2006-02-24 |
| Last Update Date | 2018-10-24 |
| Authorized Official Name | DAVID FLICEK (CEO/PRESIDENT) |
| Authorized Official Telephone | 6053228000 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SD | DAKOTACARE | 9201852 | 01 |
| IA | 0555797 | 05 | |
| MN | BLUE PLUS | 370S8ME | 01 |
| MN | BCBS | 370S8ME | 01 |
| MN | BCBS IN MN | 125K2ME | 01 |
| SD | DEPT OF LABOR | 370624200 | 01 |
| MN | PRIMEWEST | 92411422903 | 01 |
| SD | BCBS | 0040098 | 01 |
| MN | 185582400 | 05 | |
| SD | HEALTHPARTNERS | 83314 | 01 |
| Other Name | Type Code |
|---|---|
| Avera Medical Group Oncology and Hematology Sioux Falls | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154979805 | Avera Mckennan | Substance Abuse Rehabilitation Facility | 6140 S Curae Lane, Sioux Falls, SD 57108-3047 | 2019-08-27 |
| 1205311628 | Avera Mckennan | Pharmacy | 6100 S Louise Ave Ste 1100, Sioux Falls, SD 57108-6021 | 2018-10-02 |
| 1316463219 | Avera Mckennan | Pharmacy | 1200 S. 7th Avenue, Suite 101, Sioux Falls, SD 57105 | 2017-08-22 |
| 1851848444 | Avera Mckennan | Durable Medical Equipment & Medical Supplies | 2100 S Marion Road, Ste 125, Sioux Falls, SD 57106-3645 | 2016-09-01 |
| 1295187417 | Avera Mckennan | Psychiatry & Neurology | 6709 S. Minnesota Ave., Ste. 103, Sioux Falls, SD 57108-2593 | 2016-07-12 |
| 1669871000 | Avera Mckennan | Durable Medical Equipment & Medical Supplies | 3820 N Potsdam Ave Ste 2, Sioux Falls, SD 57104-7057 | 2014-08-21 |
| 1922413806 | Avera Mckennan | Clinic/Center | 400 2nd Ave, Brookings, SD 57006 | 2014-06-30 |
| 1629499132 | Avera Mckennan | Occupational Therapist | 1601 W 44th Pl, Sioux Falls, SD 57105-6376 | 2013-12-31 |
| 1700146396 | Avera Mckennan | Clinic/Center | 1035 South Highline Pl, Ste #4, Sioux Falls, SD 57110 | 2012-05-17 |
| 1467711739 | Avera Mckennan | Pharmacy | 1301 S Cliff Ave Ste 225, Sioux Falls, SD 57105-1068 | 2012-05-08 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | AVERA MCKENNAN | 1325 S Cliff Ave, Sioux Falls, SD 57105-1007 |
| Iowa Business Entities | AVERA MCKENNAN | 1325 S. Cliff St., Sioux Falls, SD 57105 |
| System for Award Management (SAM) Entities | AVERA MCKENNAN HOSPITAL & UNIVERSITY HEALTH CENTER | 1325 S Cliff Ave, Sioux Falls, SD 57105-1007 |
| Street Address |
1000 E. 23RD ST. STE. 230 |
| City | SIOUX FALLS |
| State | SD |
| Zip Code | 57105-2122 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124017256 | Michael Stephen Mchale | Internal Medicine | 1000 E. 23rd St., Ste. 230, Sioux Falls, SD 57105-2122 | 2005-10-20 |
| 1902179906 | Ahmed Galal | Internal Medicine | 1000 E. 23rd St., Ste. 200, Sioux Falls, SD 57105-2122 | 2012-02-22 |
| 1477847861 | Avera Mckennan | Radiology | 1000 E. 23rd St., Ste. 100, Sioux Falls, SD 57105-2113 | 2011-06-03 |
| 1679874242 | Jennifer Louise Reiner | Nurse Practitioner | 1000 E. 23rd St., Ste. 350, Sioux Falls, SD 57105-2113 | 2010-11-12 |
| 1609198126 | Nancy Jean Terveen | Nurse Practitioner | 1000 E. 23rd St., Ste. 230, Sioux Falls, SD 57105-2122 | 2010-02-25 |
| 1295961506 | April Joy Schnieder | Nurse Practitioner | 1000 E. 23rd St., Ste. 230, Sioux Falls, SD 57105-2122 | 2009-06-02 |
| 1932346251 | Avera Mckennan | Obstetrics & Gynecology | 1000 E. 23rd St., Ste. 350, Sioux Falls, SD 57105-2140 | 2009-01-08 |
| 1871751867 | David Charles Starks | Obstetrics & Gynecology | 1000 E. 23rd St., Ste. 350, Sioux Falls, SD 57105-2140 | 2008-05-28 |
| 1912107368 | Benjamin Maurice Solomon | Internal Medicine | 1000 E. 23rd St., Suite 230, Sioux Falls, SD 57105-2122 | 2007-07-24 |
| 1487784666 | Carole Ann Chell | Nurse Practitioner | 1000 E. 23rd St., Ste 230, Sioux Falls, SD 57105-2122 | 2007-03-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871117549 | Ashlesha Ravindra Bagwe | Student in an Organized Health Care Education/Training Program | Pediatrics Residency Program, 1305 W 18th St, Rt 6364, Sioux Falls, SD 57105 | 2020-05-29 |
| 1306494489 | Kelsey Elaine Kruse | Counselor | 3101 West 41st, Sioux Falls, SD 57105 | 2019-08-30 |
| 1902388341 | Sarah Tacke | Nurse Practitioner | 1301 West 18th Street, Sioux Falls, SD 57105 | 2018-09-02 |
| 1235624727 | Mahum Shahid | Student in an Organized Health Care Education/Training Program | 1400 W. 22nd St, Sioux Falls, SD 57105 | 2018-06-27 |
| 1942790126 | Smitha Narayana Gowda | Student in an Organized Health Care Education/Training Program | 1400 22nd Street, Sioux Falls, SD 57105 | 2018-05-14 |
| 1326538554 | Mali Elizabeth Teller | Speech-Language Pathologist | 2501 W. 26th Street, Sioux Falls, SD 57105 | 2018-05-14 |
| 1871081505 | Abdelmohaymin Abdalla Abufatima Abdalla | Student in an Organized Health Care Education/Training Program | Usd-ssom-internal Medicine Residency, 1400 22nd Street, Sioux Falls, SD 57105 | 2018-04-27 |
| 1710474697 | Moataz Ellithi | Student in an Organized Health Care Education/Training Program | 1400 W. 22nd St., Sioux Falls, SD 57105 | 2018-04-17 |
| 1366948663 | Holly Ahlers | Registered Nurse | 2000 S. Summit Ave, Sioux Falls, Sd 57105, Sioux Falls, SD 57105 | 2018-04-04 |
| 1558864124 | Darcy Lee Jensen | Counselor | 822 East 41st. Street, Suite 235, Souix Falls, SD 57105 | 2018-03-09 |
| Find all providers in zip 57105 | ||||
| Taxonomy Code | 207RH0003X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Hematology & Oncology |
| An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: definiton added, source added; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184935652 | Houman Nourkeyhani | Internal Medicine | 1000 E 23rd St Ste 230, Sioux Falls, SD 57105-2122 | 2010-06-29 |
| 1124017256 | Michael Stephen Mchale | Internal Medicine | 1000 E. 23rd St., Ste. 230, Sioux Falls, SD 57105-2122 | 2005-10-20 |
| 1437155140 | Miroslaw A Mazurczak | Internal Medicine | 1309 W 17th St, Ste 101, Sioux Falls, SD 57104-8805 | 2005-06-27 |
| 1164780201 | Avera Mckennan | Internal Medicine | 3720 W 69th St, Sioux Falls, SD 57108-8192 | 2012-04-26 |
| 1174686547 | Brian Leyland-jones | Internal Medicine | 1000 E 23rd St, Suite 200, Sioux Falls, SD 57105-2108 | 2006-12-18 |
| 1235196056 | Mchale Institute, P.C. | Internal Medicine | 3720 W 69th St, Sioux Falls, SD 57108 | 2006-04-26 |
| 1538135447 | Avera Mckennan | Internal Medicine | 1000 E. 23rd St., Ste. 200, Sioux Falls, SD 57105-2122 | 2006-02-28 |
| 1295701522 | Kelly George Mccaul | Internal Medicine | 1000 E. 23rd St., Ste. 200, Sioux Falls, SD 57105-2122 | 2006-02-27 |
| 1013983352 | Vinod Parameswaran | Internal Medicine | 1000 E. 23rd St., Ste. 200, Sioux Falls, SD 57105-2122 | 2006-02-27 |
| 1750357299 | Mark R Huber | Internal Medicine | 1000 E. 23rd St., Ste. 230, Sioux Falls, SD 57105-2122 | 2006-02-24 |
| Find all providers in SIOUX FALLS | ||||
| City | SIOUX FALLS |
| Zip Code | 57105 |
Please comment or provide details below to improve the information on AVERA MCKENNAN.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.