AVERA MCKENNAN (NPI# 1629052451) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629052451 |
| Entity Type | Organization |
| Organization Name | AVERA MCKENNAN |
| Other Organization Name | AVERA LEE MABEE OB/GYN |
| Practice Address |
1910 W 69th St Suite 100 Sioux Falls SD 57108-5612 |
| Mailing Address |
Po Box 84632 Sioux Falls SD 57118-4632 |
| Practice Telephone | 6053225260 |
| Practice Fax Number | 6053225265 |
| Mailing Telephone | 6053225260 |
| Mailing Fax Number | 6053225265 |
| Enumeration Date | 2005-12-05 |
| Last Update Date | 2017-05-31 |
| Authorized Official Name | JULIE NORTON (CFO/SVP) |
| Authorized Official Telephone | 6053227818 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207V00000X | Obstetrics & Gynecology | 2481 | SD | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WALLMARK | 0009398 | 01 | |
| MIDLANDS CHOICE | 228834 | 01 | |
| SIOUX VALLEY HEALTH PLAN | 22232 | 01 | |
| SD | 6200390 | 05 |
| Other Name | Type Code |
|---|---|
| Avera Lee Mabee OB/GYN | 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 |
1910 W 69TH ST SUITE 100 |
| City | SIOUX FALLS |
| State | SD |
| Zip Code | 57108-5612 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548523251 | Andrea Seurer | Family Medicine | 1910 W 69th St, Sioux Falls, SD 57108-5612 | 2012-06-18 |
| 1982855755 | David Ray Ulmer | Physical Therapist | 1910 W 69th St, Sioux Falls, SD 57108-5612 | 2008-10-09 |
| 1649428038 | Molly Jo Mathison | Physical Therapist | 1910 W 69th St, Avera Outpatient Therapy Clinic, Sioux Falls, SD 57108-5612 | 2008-08-28 |
| 1952568388 | Jill C Termaat | Family Medicine | 1910 W 69th St, Sioux Falls, SD 57108-5612 | 2008-05-22 |
| 1750571808 | Jason T Knutson | Family Medicine | 1910 W 69th St, Sioux Falls, SD 57108-5612 | 2007-07-25 |
| 1134324445 | Avera Mckennan | Family Medicine | 1910 W 69th St, Sioux Falls, SD 57108-5612 | 2007-06-18 |
| 1942421516 | Aaron A Prestbo | Family Medicine | 1910 W 69th St, Sioux Falls, SD 57108-5612 | 2007-05-01 |
| 1063438968 | Scott John Dierks | Family Medicine | 1910 W 69th St, Sioux Falls, SD 57108-5612 | 2006-07-14 |
| 1437194636 | Dawn Flickema | Family Medicine | 1910 W 69th St, Sioux Falls, SD 57108-5612 | 2006-06-19 |
| 1588609069 | Carilyn Vankalsbeek | Family Medicine | 1910 W 69th St, Sioux Falls, SD 57108-5612 | 2006-06-18 |
| 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 | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| 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 Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023378726 | Rachel Leigh Rodel | Obstetrics & Gynecology | 1500 W 22nd St Ste 401, Sioux Falls, SD 57105-1503 | 2012-05-29 |
| 1003188269 | Avera Mckennan | Obstetrics & Gynecology | 6100 S Louise Ave Ste 1110, Sioux Falls, SD 57108-6021 | 2012-02-03 |
| 1346556156 | Emily June Winterton | Obstetrics & Gynecology | 1417 S Cliff Ave Ste 401, Sioux Falls, SD 57105-1064 | 2010-08-31 |
| 1285738997 | Sanford Clinic | Obstetrics & Gynecology | 1201 S Euclid Ave Ste 201, Sioux Falls, SD 57105-0434 | 2006-09-12 |
| 1013965466 | Mary E Meierhenry | Obstetrics & Gynecology | 414 W 18th St, Sioux Falls, SD 57104-4810 | 2006-05-05 |
| 1942263660 | Erica Lynn Schipper | Obstetrics & Gynecology | 1500 W. 22nd St, Ste 301, Sioux Falls, SD 57105-1503 | 2006-04-11 |
| 1932183753 | Lee Maitland Mabee Jr. | Obstetrics & Gynecology | 1115 E 20th St, Sioux Falls, SD 57105-1013 | 2005-12-05 |
| 1871001941 | Davis Independent Obgyn Care, Pllc | Obstetrics & Gynecology | 414 W 18th St, Sioux Falls, SD 57104-4810 | 2018-01-11 |
| 1437666922 | Meierhenry Gynecology and Women's Healthcare PC | Obstetrics & Gynecology | 2333 W 57th St Ste 101, Sioux Falls, SD 57108 | 2018-01-05 |
| 1407207244 | Elizabeth Hultgren | Obstetrics & Gynecology | 1500 W 22nd St Ste 301, Sioux Falls, SD 57105-1503 | 2016-06-22 |
| 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.