Marty L Allison, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

SD4425 Issued in SD

Practice address

100 Mac Lane
Avera Medical Group Pierre
Pierre, SD 57501

Phone

(605) 945-5246

Fax

(605) 945-5295

NPI assigned

Feb 15, 2006

Last updated

Apr 10, 2012By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in SD

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: marty.allison@avera.sdhealthlink.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Avera McKennan

  dba Avera McKennan Behavioral Health Clinic

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Sioux Falls, SD
  • NPI 1699009944
  Medicare reassignment NPD
• Avera St Marys

  dba Avera St. Mary's Hospital

  • General Acute Care Hospital
  • Pierre, SD
  • NPI 1669457180
  Medicare reassignment NPD
• Avera McKennan

  dba Avera Interventional Radiology

  • Diagnostic Radiology Physician
  • Sioux Falls, SD
  • NPI 1053680678
  NPD
• Avera McKennan

  dba Avera Medical Group Pierre

  • Multi-Specialty Clinic/Center
  • Pierre, SD
  • NPI 1780829283
  NPD
• Avera St Marys

  dba Avera St Marys Hospital ER CRNA

  • Emergency Medicine Physician
  • Pierre, SD
  • NPI 1073305496
  NPD
• Avera St Marys

  dba Avera Pierre Clinic

  • Multi-Specialty Clinic/Center
  • Pierre, SD
  • NPI 1720326713
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1139961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334016000000",
    "number": "1013981927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MAC LANE",
            "address_2": "AVERA MEDICAL GROUP PIERRE",
            "city": "PIERRE",
            "state": "SD",
            "postal_code": "57501",
            "telephone_number": "605-945-5246",
            "fax_number": "605-945-5295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MAC LANE",
            "address_2": "AVERA MEDICAL GROUP PIERRE",
            "city": "PIERRE",
            "state": "SD",
            "postal_code": "57501",
            "telephone_number": "605-945-5246",
            "fax_number": "605-945-5295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLISON",
        "first_name": "MARTY",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-15",
        "last_updated": "2012-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "SD",
            "license": "4425",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "SD",
            "license": "SD4425",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6701220",
            "state": "SD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6701223",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lisa Alban, PA-C
• Tya Alexander, PTA
• Robert L Allison, MD
• Altegra Health Connections, LLC
• American Medical Response Ambulance Service Inc (American Medical Response (AMR))
• Anderson Dental Inc
• Charles T Anderson, DS

• Pediatrics Physician in Pierre, SD
• Providers in Pierre, SD by specialty
• Pediatrics Physician in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.