AVERA MCKENNAN (NPI# 1407829781) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407829781 |
| Entity Type | Organization |
| Organization Name | AVERA MCKENNAN |
| Other Organization Name | AVERA MEDICAL GROUP MIDWEST PSYCHIATRIC MEDICINE SIOUX FALLS |
| Practice Address |
4400 W 69th St Ste 500 Sioux Falls SD 57108 |
| Mailing Address |
Po Box 86370 Sioux Falls SD 57118-6370 |
| Practice Telephone | 6053227580 |
| Practice Fax Number | 6053227579 |
| Mailing Telephone | 6053227510 |
| Mailing Fax Number | 6053226475 |
| Enumeration Date | 2006-02-08 |
| 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 | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SD | DEPT OF LABOR | 370624200 | 01 |
| SD | HEALTHPARTNERS | 65742 | 01 |
| IA | 0211607 | 05 | |
| SD | BCBS | 0006118 | 01 |
| SD | PRIMEWEST | 92411422904 | 01 |
| MN | BLUE PLUS | 3T021SC | 01 |
| MN | 293011100 | 05 |
| Other Name | Type Code |
|---|---|
| Avera Medical Group Midwest Psychiatric 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 |
4400 W 69TH ST STE 500 |
| City | SIOUX FALLS |
| State | SD |
| Zip Code | 57108 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023080595 | Sarah A Flynn | Psychiatry & Neurology | 4400 W 69th St, Ste 1500, Sioux Falls, SD 57108-8170 | 2006-02-07 |
| 1609494483 | Hannah Otten | Nurse Practitioner | 4400 W 69th St, Sioux Falls, SD 57108-8170 | 2020-07-08 |
| 1265096739 | Chelsea Oppold | Social Worker | 4400 W 69th St, Sioux Falls, SD 57108-8170 | 2019-04-30 |
| 1891358248 | Paige Elizabeth Thompson | Social Worker | 4400 W 69th St, Sioux Falls, SD 57108-8170 | 2019-04-20 |
| 1982198776 | Jennifer Assam | Student in an Organized Health Care Education/Training Program | 4400 W 69th St, Sioux Falls, SD 57108-8170 | 2018-06-15 |
| 1184150468 | Gerard J Kokett | Pharmacist | 4400 W 69th St, Sioux Falls, SD 57108-8170 | 2017-05-05 |
| 1851823892 | Matthew Malecha | Student in an Organized Health Care Education/Training Program | 4400 W 69th St, Sioux Falls, SD 57108-8170 | 2017-03-29 |
| 1992254072 | Jenna Visser | Social Worker | 4400 W 69th St, Sioux Falls, SD 57108-8170 | 2016-09-29 |
| 1134674476 | Julia Alzoubaidi | Psychologist | 4400 W 69th St, Ste 1500, Sioux Falls, SD 57108-8170 | 2016-08-16 |
| 1598131831 | Amber Marie Reints | Nurse Practitioner | 4400 W 69th St, Sioux Falls, SD 57108-8170 | 2015-08-20 |
| Find all providers in the same location | ||||
| 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 | 2084P0800X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Psychiatry |
| A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619321197 | Erik Peterson | Psychiatry & Neurology | Sioux Falls Va Medical Center, 2501 West 22nd St, Sioux Falls, SD 57105 | 2016-04-20 |
| 1942325428 | Francis Christopher Bandettini | Psychiatry & Neurology | 2500 W 49th St, Suite 206, Sioux Falls, SD 57105-6580 | 2007-03-21 |
| 1396764254 | Sanford Clinic | Psychiatry & Neurology | 2400 W 49th St, Sioux Falls, SD 57105-6581 | 2006-07-19 |
| 1982640892 | Kannan Clinic, P.C. | Psychiatry & Neurology | 5120 S Western Ave, Ste. 104, Sioux Falls, SD 57108-5013 | 2006-06-20 |
| 1700858248 | Anthony M Vaca | Psychiatry & Neurology | 4400 W 69th St., Ste. 1500, Sioux Falls, SD 57108-8171 | 2006-02-07 |
| 1871565333 | Lisa Carol Amiotte | Psychiatry & Neurology | 4400 W. 69th St, Ste. 500, Sioux Falls, SD 57108-8171 | 2006-02-07 |
| 1013980598 | Avera Mckennan | Psychiatry & Neurology | 4400 W 69th St Ste 1500, Sioux Falls, SD 57108-8171 | 2006-02-07 |
| 1700499936 | Avera Mckennan | Psychiatry & Neurology | 4500 N Lewis Ave, Sioux Falls, SD 57104-7111 | 2020-08-27 |
| 1184116709 | Laura Jane Pfeiffer | Psychiatry & Neurology | 2000 S Summit Ave, Sioux Falls, SD 57105-2727 | 2018-05-30 |
| 1568967446 | Courtnee Renee Heyduk | Psychiatry & Neurology | 1400 W 22nd St, Sioux Falls, SD 57105-1554 | 2018-03-24 |
| Find all providers in SIOUX FALLS | ||||
| City | SIOUX FALLS |
| Zip Code | 57108 |
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.