Individual provider Active NPI

Jessie Lynn Graney, PHARM.D.

  • Pharmacist
  • Sioux Falls, SD
National Provider Identifier
1093967192
Registry record updated Jul 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
5403 Issued in SD
Practice address
6100 S Louise Ave Ste 1100
Sioux Falls, SD 57108-6030
Phone
(605) 504-1351
Fax
(605) 504-1352
NPI assigned
Oct 21, 2008
Last updated
Jul 31, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 20473 IA
Pharmacist 183500000X 118228 MN
Pharmacist 183500000X 12433 NE
Pharmacist 183500000X 5403 SD Primary

Addresses

Primary practice location

6100 S Louise Ave Ste 1100
Sioux Falls, SD 57108-6030

Mailing address

6100 S Louise Ave Ste 1100
Sioux Falls, SD 57108-6030
Phone (605) 504-1351

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
12433NEMDMental Health Counselor
20473IAMDPharmacist
118228MNMDPharmacist
5403SDMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Avera McKennan CurrentSince Aug 6, 2023 Accepting new patients
Avera McKennan PastSince Aug 6, 2023 Accepting new patients

Locations

6100 S Louise Ave
Ste 1100
Sioux Falls, SD 57108
Phone (605) 322-8630

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1224547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690761600000",
    "number": "1093967192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6100 S LOUISE AVE STE 1100",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571086030",
            "telephone_number": "605-504-1351",
            "fax_number": "605-504-1352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6100 S LOUISE AVE STE 1100",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571086030",
            "telephone_number": "605-504-1351",
            "fax_number": "605-504-1352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANEY",
        "first_name": "JESSIE",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "PHARM.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-21",
        "last_updated": "2023-07-31",
        "certification_date": "2022-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IA",
            "license": "20473",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MN",
            "license": "118228",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NE",
            "license": "12433",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "SD",
            "license": "5403",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sioux Falls, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.