Active NPI
Avera McKennan
Doing business as Avera Medical Group Milbank
- Family Medicine Physician
- Milbank, SD
National Provider Identifier
1114594868
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- Legal business name
- AVERA MCKENNAN
- Doing business as
- Avera Medical Group Milbank
- Practice address
- 301 Flynn Dr
Milbank, SD 57252-1508 - Phone
- (605) 432-4587
- Fax
- (605) 432-4580
- NPI assigned
- Jun 9, 2021
- Last updated
- Jun 9, 2021
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- David William Flicek
- Title
- President/Ceo
- Phone
- (605) 322-7915
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | |||
| Family Medicine Physician | 207Q00000X | Primary | ||
| Internal Medicine Physician | 207R00000X | |||
| Physician Assistant | 363A00000X | |||
| Nurse Practitioner | 363L00000X |
Addresses
Primary practice location
301 Flynn Dr
Milbank, SD 57252-1508
Mailing address
PO Box 5045 PFS Prov Enrlmt Palm Place
Sioux Falls, SD 57117-5045
Other names 1
- Avera Medical Group Milbank
National Provider Directory
National Provider Directory- Tax ID family
- Presentation Health Sys
Organizations with this tax ID in the same state 20
This tax ID family is large, so up to 24 of its organizations in the same state are linked here.
-
dba Avera Medical Group Addiction Medicine
- Addiction Medicine (Psychiatry & Neurology) Physician
- Sioux Falls, SD
- NPI 1013668698
-
dba Avera Dialysis Mitchell
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Mitchell, SD
- NPI 1023413093
-
dba Avera Medical Group McGreevy 69th & Minnesota Pediatrics
- Pediatrics Physician
- Sioux Falls, SD
- NPI 1033405436
-
dba Avera Prince of Peace Assisted Living
- Assisted Living Facility
- Sioux Falls, SD
- NPI 1053556068
-
dba Avera Interventional Radiology
- Diagnostic Radiology Physician
- Sioux Falls, SD
- NPI 1053680678
-
dba Avera Medical Group Brookings
- Clinical Medical Laboratory
- Brookings, SD
- NPI 1063782373
-
dba Avera Medical Group Health Care Clinic Sioux Falls
- Internal Medicine Physician
- Sioux Falls, SD
- NPI 1083894067
-
dba Avera Children's
- Pediatric Hematology & Oncology Physician
- Sioux Falls, SD
- NPI 1144488537
-
dba Avera Medical Group 69th and Cliff
- Family Medicine Physician
- Sioux Falls, SD
- NPI 1144635863
-
dba Avera McKennan Hospital and University Health Center - Diabetic Ed
- General Acute Care Hospital
- Sioux Falls, SD
- NPI 1154531630
-
dba Avera Addiction Care Center
- Substance Abuse Rehabilitation Facility
- Sioux Falls, SD
- NPI 1154979805
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1623196800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1623196800000",
"number": "1114594868",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 5045 PFS PROV ENRLMT PALM PLACE",
"city": "SIOUX FALLS",
"state": "SD",
"postal_code": "571175045"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "301 FLYNN DR",
"city": "MILBANK",
"state": "SD",
"postal_code": "572521508",
"telephone_number": "605-432-4587",
"fax_number": "605-432-4580"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "AVERA MCKENNAN",
"organizational_subpart": "NO",
"enumeration_date": "2021-06-09",
"last_updated": "2021-06-09",
"certification_date": "2021-06-09",
"status": "A",
"authorized_official_last_name": "FLICEK",
"authorized_official_first_name": "DAVID",
"authorized_official_middle_name": "WILLIAM",
"authorized_official_title_or_position": "PRESIDENT/CEO",
"authorized_official_telephone_number": "605-322-7915"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": null,
"license": null,
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": null,
"license": null,
"primary": true
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": null,
"license": null,
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": null,
"license": null,
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Avera Medical Group Milbank",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Milbank, SD
- Nevin John Andreas, OT
- Avera at Home (Avera @ Home)
- Avera at Home (Avera @ Home)
- Avera McKennan (Milbank Area Hospital After Hours Clinic)
- Avera McKennan (Milbank Area Hospital/Avera Health- Swingbed)
- Avera McKennan (Milbank Area Hospital/Avera Health)
- Avera McKennan (Avera Medical Group Milbank)
- Avera McKennan (Avera Dialysis Milbank)
- James Keith Bailey, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.