AVERA MCKENNAN (NPI# 1932477098) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1932477098 |
Entity Type | Organization |
Organization Name | AVERA MCKENNAN |
Other Organization Name | AVERA MEDICAL GROUP COMPREHENSIVE BREAST CARE SIOUX FALLS |
Practice Address |
1000 E 23rd St Ste 360 Sioux Falls SD 57105-2140 |
Mailing Address |
Po Box 86370 Sioux Falls SD 57118-6370 |
Practice Telephone | 6053223950 |
Practice Fax Number | 6053321617 |
Mailing Telephone | 6053227510 |
Mailing Fax Number | 6053226475 |
Enumeration Date | 2011-12-05 |
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 | 208600000X | Surgery | Allopathic & Osteopathic Physicians |
Other Name | Type Code |
---|---|
Avera Medical Group Comprehensive Breast Care 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 |
1000 E 23RD ST STE 360 |
City | SIOUX FALLS |
State | SD |
Zip Code | 57105-2140 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1417449562 | Austin Jay Huber | Genetic Counselor, MS | 1000 E 23rd St Ste 360, Sioux Falls, SD 57105-2140 | 2018-06-05 |
1891050597 | Traci Marie Redmond | Nurse Practitioner | 1000 E 23rd St Ste 360, Sioux Falls, SD 57105-2140 | 2012-07-09 |
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 | 208600000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Surgery |
A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1730410465 | Philip Felix Winskunas | Surgery | 6019 E. Powderhouse Circle, Sioux Falls, SD 57110-7468 | 2010-01-20 |
1295991370 | Comprehensive Breast Care PC | Surgery | 911 E 20th St Ste 400, Sioux Falls, SD 57105-1046 | 2008-07-29 |
1740490499 | Laura M Figura | Surgery | 1417 S Cliff Ave Ste 200, Sioux Falls, SD 57105-1009 | 2007-05-23 |
1184724742 | Gail Waldby | Surgery | 3700 S Westport Ave # 3014, Sioux Falls, SD 57106-6360 | 2006-09-24 |
1750332110 | Robert K Dahl | Surgery | 911 E 20th St Ste 501, Sioux Falls, SD 57105-1047 | 2006-05-12 |
1255317038 | Jason Knudtson | Surgery | 1508 W 22nd St, Ste 101, Sioux Falls, SD 57105-1508 | 2005-12-22 |
1235796533 | Upper Midwest Medical Inc | Surgery | 4201 S Minnesota Ave Ste 112, Sioux Falls, SD 57105-6706 | 2019-05-22 |
1407194996 | Hassan Al Turaihi | Surgery | 1508 W 22nd St Ste 101, Sioux Falls, SD 57105-1514 | 2013-01-18 |
1467744201 | Stephanie Y Hung | Surgery | 2501 W. 22nd Street, Att: Dr. Hung, Sioux Falls, SD 57105 | 2011-05-12 |
1750680286 | Michael Joseph Brozik | Surgery | 911 E 20th St Ste 700, Sioux Falls, SD 57105 | 2011-03-23 |
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.