AVERA MCKENNAN (NPI# 1417246901) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1417246901 |
Entity Type | Organization |
Organization Name | AVERA MCKENNAN |
Other Organization Name | AVERA MEDICAL GROUP OPHTHALMOLOGY SIOUX FALLS |
Practice Address |
911 E 20th St Ste 101 Sioux Falls SD 57105-1043 |
Mailing Address |
Po Box 86370 Sioux Falls SD 57118-6370 |
Practice Telephone | 6053223790 |
Practice Fax Number | 6053223791 |
Mailing Telephone | 6053227510 |
Enumeration Date | 2011-04-05 |
Last Update Date | 2019-11-25 |
Authorized Official Name | DAVID FLICEK (SENIOR VP OF FINANCE) |
Authorized Official Telephone | 6053227915 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 152W00000X | Optometrist | Eye and Vision Services Providers | ||
Y | 207W00000X | Ophthalmology | Allopathic & Osteopathic Physicians |
Other Name | Type Code |
---|---|
Avera Medical Group Eye Care | Doing Business As Name - Organization |
Avera Medical Group Ophthalmology 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 |
911 E 20TH ST STE 101 |
City | SIOUX FALLS |
State | SD |
Zip Code | 57105-1043 |
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 | 207W00000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Ophthalmology |
An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses. |
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 Ophthalmology, 2007. http://www.abop.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Ophthalmology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1588120349 | Art Vision | Ophthalmology | 2101 W 69th St Ste 204, Sioux Falls, SD 57108-5621 | 2019-02-18 |
1619096096 | Norman Lewis | Ophthalmology | 4900 S Oxbow Ave, #210, Sioux Falls, SD 57106-4141 | 2007-03-28 |
1942253919 | Ken D Augspurger | Ophthalmology | 1621 S Minnesota Ave, Sioux Falls, SD 57105-1743 | 2006-05-18 |
1588636484 | Eric R Thomas | Ophthalmology | 6601 S Minnesota Ave Ste 200, Sioux Falls, SD 57108 | 2006-02-03 |
1205812328 | Alison R Tendler | Ophthalmology | 2101 W 69th St Unit 204, Sioux Falls, SD 57108-5624 | 2005-12-20 |
1871589531 | Ophthalmology Ltd | Ophthalmology | 6601 S Minnesota Ave, Suite 200, Sioux Falls, SD 57108-2564 | 2005-09-27 |
1427055896 | Thomas Clement White | Ophthalmology | 1701 S Minnesota Ave, Sioux Falls, SD 57105-1751 | 2005-06-30 |
1073519989 | Vance Michael Thompson | Ophthalmology | 3101 W 57th St, Sioux Falls, SD 57108-3162 | 2005-06-24 |
1053979906 | Art Surgical, LLC | Ophthalmology | 2101 W 69th St Ste 204, Sioux Falls, SD 57108-5621 | 2019-06-04 |
1033627674 | Michael Wayne Pekas | Ophthalmology | 2501 W 22nd St, Sioux Falls, SD 57105-1305 | 2018-01-17 |
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.