AVERA MCKENNAN (NPI# 1093262131) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1093262131 |
Entity Type | Organization |
Organization Name | AVERA MCKENNAN |
Other Organization Name | AVERA MEDICAL GROUP ORTHOPEDICS AND SPORTS MEDICINE |
Practice Address |
6100 S Louise Ave Ste 2100 Sioux Falls SD 57108-6021 |
Mailing Address |
Po Box 86370 Sioux Falls SD 57118-6370 |
Practice Telephone | 6055041100 |
Mailing Telephone | 6053227510 |
Enumeration Date | 2016-09-07 |
Last Update Date | 2020-07-15 |
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 |
---|---|---|---|---|---|
N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
Y | 207X00000X | Orthopaedic Surgery | Allopathic & Osteopathic Physicians |
Other Name | Type Code |
---|---|
Avera Medical Group Orthopedics and Sports Medicine | Doing Business As Name - Organization |
Address | Telephone Number | Fax Number |
---|---|---|
911 E. 20th St., Ste. 300, Sioux Falls, SD 571051045 | 6053221300 | 6053221301 |
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 |
6100 S LOUISE AVE STE 2100 |
City | SIOUX FALLS |
State | SD |
Zip Code | 57108-6021 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1982821898 | Michael Coale Devish | Orthopaedic Surgery | 6100 S Louise Ave Ste 2100, Sioux Falls, SD 57108-6021 | 2007-04-20 |
1124437595 | Ruth Ranum Moen | Podiatrist | 6100 S Louise Ave Ste 2100, Sioux Falls, SD 57108-6029 | 2014-08-10 |
1326461088 | Tyler Ray Krome | Physician Assistant | 6100 S Louise Ave Ste 2100, Sioux Falls, SD 57108-6021 | 2014-01-30 |
1447509203 | Rocio Carolina Fuentes Barrow | Orthopaedic Surgery | 6100 S Louise Ave Ste 2100, Sioux Falls, SD 57108-6021 | 2012-09-07 |
1679860548 | Brian Thomas Dix | Podiatrist | 6100 S Louise Ave Ste 2100, Sioux Falls, SD 57108-6021 | 2011-06-29 |
1386975530 | Kerry Louise Vanoverbeke | Physician Assistant | 6100 S Louise Ave Ste 2100, Sioux Falls, SD 57108-6021 | 2010-01-27 |
1467654509 | Garrison Lawrence Whitaker | Orthopaedic Surgery | 6100 S Louise Ave Ste 2100, Sioux Falls, SD 57108-6021 | 2007-06-01 |
1730396904 | Matthew Blake | Orthopaedic Surgery | 6100 S Louise Ave Ste 2100, Sioux Falls, SD 57108-6021 | 2007-05-17 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1134735764 | Faith Carlson | Counselor | 5621 S. Southeastern Avenue, Suite 5625, Sioux Falls, SD 57108 | 2020-09-18 |
1063020196 | Emily Mensen | Physical Therapist | 4700 W 69th St, Sioux Falls, Sioux Falls, SD 57108 | 2020-07-15 |
1528695798 | Allison Mcentee | Physician Assistant | 3620 East Prairiewind Street, Sioux Falls, SD 57108 | 2020-03-26 |
1265935829 | Sioux Falls Audiology Associates | Clinic/Center | 4948 E. 57th Street, Sioux Falls, SD 57108 | 2018-03-09 |
1184124935 | Haley Elizabeth Luond | Chiropractor | 4900 E 57th Street, Suite B, Sioux Falls, SD 57108 | 2018-02-19 |
1770098881 | Yinan Zhao | Acupuncturist | 6001 S Sharon Ave Ste 6, Sioux Falls, SD 57108 | 2017-12-12 |
1447780796 | Sioux Falls Specialty Hospital, LLP | Special Hospital | 7600 South Minnesota Ave, Sioux Falls, SD 57108 | 2017-06-19 |
1952831786 | Brock T Nelsen | Dentist | 5121 S Solberg Ave #120, Sioux Falls, SD 57108 | 2017-06-14 |
1629517552 | Sarah Kenyon | Chiropractor | 6116 S Lyncrest Ave Ste 105, Sioux Falls, SD 57108 | 2017-02-12 |
1386029460 | Michelle Anne Pliska | Counselor | 5621 Southeastern Ave, Sioux Falls, SD 57108 | 2015-07-30 |
Find all providers in zip 57108 |
Taxonomy Code | 207X00000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Orthopaedic Surgery |
An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. American Osteopathic Board of Orthopaedic Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Orthopaedic Surgery. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1598325375 | Osd Care of Sd, LLC | Orthopaedic Surgery | 519 W 22nd St Ste 100, Sioux Falls, SD 57105-1745 | 2019-06-14 |
1982821898 | Michael Coale Devish | Orthopaedic Surgery | 6100 S Louise Ave Ste 2100, Sioux Falls, SD 57108-6021 | 2007-04-20 |
1861615155 | Patrick Mark O'brien | Orthopaedic Surgery | 911 E 20th St Ste 300, Sioux Falls, SD 57105-1045 | 2007-04-11 |
1144232042 | Travis Richard Liddell | Orthopaedic Surgery | 2908 E. 26th St., Sioux Falls, SD 57103-4034 | 2006-08-12 |
1679524805 | Thomas A Ambrose II | Orthopaedic Surgery | 911 E. 20th St., Ste. 300, Sioux Falls, SD 57105-1045 | 2006-05-12 |
1437123320 | Erik Douglas Peterson | Orthopaedic Surgery | 810 E 232rd St, Sioux Falls, SD 57105 | 2006-02-15 |
1275530644 | Timothy L Walker | Orthopaedic Surgery | 1210 W 18th St Ste G01, Sioux Falls, SD 57104-4651 | 2005-06-30 |
1861022543 | Manus, LLC | Orthopaedic Surgery | 810 E 23rd St, Sioux Falls, SD 57105-2135 | 2020-01-22 |
1669735676 | Harvey Anthony Oliver IIi | Orthopaedic Surgery | 1210 W 18th St Ste G01, Sioux Falls, SD 57104-4651 | 2012-06-25 |
1366702326 | Jonathon Ross Geisinger | Orthopaedic Surgery | 810 E 23rd St, Sioux Falls, SD 57105 | 2012-05-24 |
Find all providers in SIOUX FALLS |
City | SIOUX FALLS |
Zip Code | 57108 |
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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.