AVERA MCKENNAN (NPI# 1386081883) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386081883 |
| Entity Type | Organization |
| Organization Name | AVERA MCKENNAN |
| Other Organization Name | AVERA MEDICAL GROUP INTEGRATIVE MEDICINE SIOUX FALLS |
| Practice Address |
1000 E 23rd St Ste. 140 Sioux Falls SD 57105-2114 |
| Mailing Address |
Po Box 86370 Sioux Falls SD 57118-6370 |
| Practice Telephone | 6053223241 |
| Mailing Telephone | 6053227510 |
| Enumeration Date | 2013-05-24 |
| 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 | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Avera Medical Group Integrative Medicine 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. 140 |
| City | SIOUX FALLS |
| State | SD |
| Zip Code | 57105-2114 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639172349 | Casey Benjamin Williams | Pharmacist | 1000 E 23rd St, Suite 200, Sioux Falls, SD 57105-2108 | 2005-05-27 |
| 1518582253 | Sydney Ann Strait | Genetic Counselor, MS | 1000 E 23rd St, Sioux Falls, SD 57105-2108 | 2020-06-09 |
| 1265930184 | Brenda Lee Ling | Social Worker | 1000 E 23rd St, Sioux Falls, SD 57105-2108 | 2018-01-25 |
| 1386005056 | Laura Hofer | Physician Assistant | 1000 E 23rd St, 230, Sioux Falls, SD 57105-2108 | 2016-03-09 |
| 1124409495 | Alexandra Erickson | Physical Therapist | 1000 E 23rd St, Sioux Falls, SD 57105-2108 | 2015-06-12 |
| 1558609107 | Tavane Elizabeth Harrison | Nurse Practitioner | 1000 E 23rd St, Sioux Falls, SD 57105-2108 | 2013-01-16 |
| 1225300312 | Jessica Dawn Klein | Nurse Practitioner | 1000 E 23rd St, Sioux Falls, SD 57105-2108 | 2012-02-03 |
| 1588997365 | Avera Mckennan | Clinic/Center | 1000 E 23rd St, Suite 330, Sioux Falls, SD 57105-2113 | 2009-09-11 |
| 1467695767 | Avera Mckennan | Clinic/Center | 1000 E 23rd St, Suite 330, Sioux Falls, SD 57105-2113 | 2009-04-16 |
| 1215135348 | Elizabeth Ann O'neill | Nurse Practitioner | 1000 E 23rd St, Suite #230, Sioux Falls, SD 57105-2108 | 2007-07-10 |
| 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 | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427555002 | Sanford Clinic | Family Medicine | 136 S Phillips Ave Ste 102, Sioux Falls, SD 57104 | 2018-04-10 |
| 1023524741 | Quick Health Urgent Care LLC | Family Medicine | 7600 S Louise Ave Ste 150, Sioux Falls, SD 57108-5999 | 2017-12-18 |
| 1104246297 | Kayla Norenberg | Family Medicine | 6110 S. Minnesota Avenue, Sioux Falls, SD 57108-2571 | 2014-04-16 |
| 1427492206 | Nelly O Boyt | Family Medicine | 3524 S Spencer Blvd, Sioux Falls, SD 57103-4653 | 2013-04-23 |
| 1346512266 | Avera Mckennan | Family Medicine | 1035 South Highline Place, Sioux Falls, SD 57110-1000 | 2012-02-08 |
| 1699005074 | Avera Mckennan | Family Medicine | 930 E 6th St, Sioux Falls, SD 57103-1306 | 2010-01-06 |
| 1508196981 | Avera Mckennan | Family Medicine | 1200 E 3rd St, Sioux Falls, SD 57103-0901 | 2010-01-06 |
| 1912153578 | Avera Mckennan | Family Medicine | 501 N Sycamore Ave, Sioux Falls, SD 57110-5752 | 2008-08-14 |
| 1538315353 | Michael P. Crandell | Family Medicine | 300 Cherapa Pl, Suite 201, Sioux Falls, SD 57103-2269 | 2008-08-12 |
| 1225293996 | Jerry Leroi Walton | Family Medicine | 4310 S Minnesota Ave, Sioux Falls, SD 57105-6747 | 2008-07-22 |
| Find all providers in SIOUX FALLS | ||||
| City | SIOUX FALLS |
| Zip Code | 57105 |
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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.