AVERA MCKENNAN (NPI# 1609848175) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609848175 |
| Entity Type | Organization |
| Organization Name | AVERA MCKENNAN |
| Other Organization Name | AVERA KANNAN CLINIC |
| Practice Address |
911 E 20th St Ste. 403 Sioux Falls SD 57105-1042 |
| Mailing Address |
2400 S Minnesota Ave. Ste 100 Sioux Falls SD 57105-3762 |
| Practice Telephone | 6053227516 |
| Practice Fax Number | 6053227519 |
| Mailing Telephone | 6053227510 |
| Mailing Fax Number | 6053226475 |
| Enumeration Date | 2006-02-07 |
| Last Update Date | 2012-03-27 |
| Authorized Official Name | JULIE N NORTON (SENIOR VP OF FINANCE) |
| Authorized Official Telephone | 6053226375 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Avera Kannan Clinic | 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. 403 |
| City | SIOUX FALLS |
| State | SD |
| Zip Code | 57105-1042 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972506939 | Dakota Surgical Ltd | Clinic/Center | 911 E 20th St, Ste 300, Sioux Falls, SD 57105-1045 | 2005-05-24 |
| 1487008686 | Shelly Rae Tibke | Registered Nurse | 911 E 20th St, Ste 700, Sioux Falls, SD 57105-1049 | 2016-04-14 |
| 1447507660 | Dana J Buus | Nurse Practitioner | 911 E 20th St, Suite 405, Sioux Falls, SD 57105-1042 | 2012-08-07 |
| 1912267030 | Oluma Yoseph Bushen | Internal Medicine | 911 E 20th St, Suite 509, Sioux Falls, SD 57105-1042 | 2012-05-23 |
| 1942572086 | Trichelle Grace Petermann | Nurse Practitioner | 911 E 20th St, Ste 400, Sioux Falls, SD 57105-1042 | 2012-02-06 |
| 1770813651 | Gwen Lynn Smith | Physician Assistant | 911 E 20th St, Ste 700, Sioux Falls, SD 57105-1049 | 2009-12-28 |
| 1578783213 | Virginia K Trumbull | Dietitian, Registered | 911 E 20th St, Physicians Office Building, Suite 600, Sioux Falls, SD 57105-1042 | 2007-04-26 |
| 1093833840 | Michael R. Puumala, M.d.,p.c. | Specialist | 911 E 20th St, Suite 400, Sioux Falls, SD 57105-1042 | 2007-03-27 |
| 1174647655 | Mary E. Kinney | Registered Nurse | 911 E 20th St, Sioux Falls, SD 57105-1042 | 2007-03-19 |
| 1699818252 | Delaina Patricia Sievers | Physician Assistant | 911 E 20th St, Suite 303, Sioux Falls, SD 57105-1042 | 2007-02-14 |
| 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 | 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 | 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.