NPIMap

Individual provider Active NPI

Jonathon Bannwarth

  • Family Medicine Physician
  • Sioux Falls, SD
National Provider Identifier
1184044273
Registry record updated Apr 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
10427 Issued in SD
Practice address
2100 S Marion Rd
Sioux Falls, SD 57106-3646
Phone
(605) 322-1010
Fax
(605) 322-1011
NPI assigned
Apr 16, 2014
Last updated
Apr 15, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 10427 SD Primary

Addresses

Primary practice location

2100 S Marion Rd
Sioux Falls, SD 57106-3646

Mailing address

1200 S 7TH Ave
Sioux Falls, SD 57105-0900
Phone (605) 322-1010

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170731003645 SD Practitioner - Family Practice 1557588530 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Sanford School of Medicine of University of South Dakota, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Avera McKennanGroup PAC ID 0345157103, 957 clinicians

Practice addresses (Care Compare)

2100 S Marion Rd
Suite 300
Sioux Falls, SD 57106-3650
Phone (605) 322-8920

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions35
Removal of nail tissue1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Avera McKennan CurrentSince Aug 1, 2017 Accepting new patients
Avera McKennan Family Medicine CurrentSince Aug 1, 2017 Accepting new patients
Avera McKennan Current Accepting new patients

Locations

1200 S 7th Ave
Sioux Falls, SD 57105
Phone (605) 336-2140

2100 S Marion Rd
Sioux Falls, SD 57106
Phone (605) 322-1010

2100 S Marion Rd
Ste 300
Sioux Falls, SD 57106
Phone (605) 322-1300

Interoperability endpoints

  • Direct secure messaging: jonathon.bannwarth@avera.sdhealthlink.net

Organizations & group practices 3

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.

Hospital & facility affiliations 25

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1397606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649980800000",
    "number": "1184044273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 S 7TH AVE",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571050900",
            "telephone_number": "605-322-1010",
            "fax_number": "605-322-1011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 S MARION RD",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571063646",
            "telephone_number": "605-322-1010",
            "fax_number": "605-322-1011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANNWARTH",
        "first_name": "JONATHON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-16",
        "last_updated": "2022-04-15",
        "certification_date": "2022-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SD",
            "license": "10427",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sioux Falls, SD

Sources for this page

Verify at the official NPI Registry.