AVERA MCKENNAN (NPI# 1700499936) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700499936 |
| Entity Type | Organization |
| Organization Name | AVERA MCKENNAN |
| Practice Address |
4500 N Lewis Ave Sioux Falls SD 57104-7111 |
| Mailing Address |
2300 E 54th St N Sioux Falls SD 57104-8809 |
| Practice Telephone | 6053226368 |
| Mailing Telephone | 6053226368 |
| Enumeration Date | 2020-08-27 |
| Last Update Date | 2020-08-27 |
| Authorized Official Name | DAVID WILLIAM FLICEK (CEO/PRESIDENT) |
| Authorized Official Telephone | 6053227915 |
| 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 eCARE | 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 |
4500 N LEWIS AVE |
| City | SIOUX FALLS |
| State | SD |
| Zip Code | 57104-7111 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619989605 | Janell L Simpkins | Emergency Medicine | 4500 N Lewis Ave, Sioux Falls, SD 57104 | 2006-08-11 |
| 1902417983 | Ephrem Tadesse Bejiga | Nurse Practitioner | 4500 N Lewis Ave, Sioux Falls, SD 57104-7111 | 2020-08-12 |
| 1790393825 | Anders Peterson | Nurse Practitioner | 4500 N Lewis Ave, Sioux Falls, SD 57104-7111 | 2020-07-15 |
| 1982231510 | Collin Jansen Block | Social Worker | 4500 N Lewis Ave, Sioux Falls, SD 57104-7111 | 2020-03-24 |
| 1245886746 | Mitchell Jacob Relf | Nurse Practitioner | 4500 N Lewis Ave, Sioux Falls, SD 57104-7111 | 2019-08-12 |
| 1073167953 | Kenna Lyn Kennedy | Nurse Practitioner | 4500 N Lewis Ave, Sioux Falls, SD 57104-7111 | 2019-07-29 |
| 1548733116 | Jacklyn Genzlinger | Social Worker | 4500 N Lewis Ave, Sioux Falls, SD 57104-7111 | 2019-01-07 |
| 1134619596 | Jennifer Marie Prouty | Social Worker | 4500 N Lewis Ave, Sioux Falls, SD 57104-7111 | 2018-05-11 |
| 1639694532 | Anasara Henry | Nurse Practitioner | 4500 N Lewis Ave, Sioux Falls, SD 57104-7111 | 2017-08-11 |
| 1033539937 | Adam Peterson | Psychiatry & Neurology | 4500 N Lewis Ave, Sioux Falls, SD 57104-7111 | 2014-04-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518594134 | Melissa Bader | Nurse Practitioner | 1112 S. Lake Ave, Suite 201, Sioux Falls, SD 57104 | 2020-03-24 |
| 1457995714 | Sanford Clinic | Clinic/Center | 1112 S Lake Ave, Ste 201, Sioux Falls, SD 57104 | 2019-10-30 |
| 1427555002 | Sanford Clinic | Family Medicine | 136 S Phillips Ave Ste 102, Sioux Falls, SD 57104 | 2018-04-10 |
| 1033637210 | Anna Peasley | Speech-Language Pathologist | 710 W 18th St, Sioux Falls, SD 57104 | 2017-09-07 |
| 1699204313 | Sioux Falls Primary Home Care Services LLC | In Home Supportive Care | 201 N Minnesota Ave Ste 101l, Sioux Falls, SD 57104 | 2017-06-06 |
| 1093258808 | Megan Regina Wexler | Social Worker | 4510 N Lewis Ave, Sioux Falls, SD 57104 | 2016-11-28 |
| 1831645498 | Ryan Ortiz | Specialist/Technologist | 1908 1/2 Old Town Rd Nw, Albuquerque, NM 57104 | 2016-09-01 |
| 1881140622 | Kristine Carol Smith | Occupational Therapist | 601 N. Spring Ave, Hawthorne Elementary, Sioux Falls, SD 57104 | 2016-08-31 |
| 1215299292 | Jolene Mitchell | Preventive Medicine | 900 E 54th St N Ste 100, Sioux Falls, SD 57104 | 2012-06-14 |
| 1871874651 | Christine Marie Burg | Pharmacist | 2503 East 54th Street N., Medvantx Pharmacy Services, Sioux Falls, SD 57104 | 2011-09-07 |
| Find all providers in zip 57104 | ||||
| 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 |
| 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 |
| 1265977243 | Concordia Mind Health Inc | Psychiatry & Neurology | 6810 S Lyncrest Ave Ste 201, Sioux Falls, SD 57108-2515 | 2016-12-29 |
| Find all providers in SIOUX FALLS | ||||
| City | SIOUX FALLS |
| Zip Code | 57104 |
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.