Active NPI
Avera McKennan
Doing business as Avera Medical Group Palliative Medicine Sioux Falls
- Hospice and Palliative Medicine (Internal Medicine) Physician
- Sioux Falls, SD
National Provider Identifier
1356629497
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hospice and Palliative Medicine (Internal Medicine) Physician
- Legal business name
- AVERA MCKENNAN
- Doing business as
- Avera Medical Group Palliative Medicine Sioux Falls
- Practice address
- 911 E 20TH St Ste 400
Sioux Falls, SD 57105-1046 - Phone
- (605) 322-8993
- Fax
- (605) 322-7631
- NPI assigned
- Jul 22, 2011
- Last updated
- Aug 4, 2020
- 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 Flicek
- Title
- Ceo/President
- Phone
- (605) 322-8000
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hospice and Palliative Medicine (Internal Medicine) Physician | 207RH0002X | NU | Primary |
Addresses
Primary practice location
911 E 20TH St Ste 400
Sioux Falls, SD 57105-1046
Mailing address
PO Box 86370
Sioux Falls, SD 57118-6370
Phone (605) 322-7510
Other names 1
- Avera Medical Group Palliative Medicine Sioux Falls
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SD
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031110000117 | SD | Part B Supplier - Clinic/Group Practice | 0345157103 |
Receives reassigned benefits from 1,418 practitioners This NPI is an additional NPI on the enrollment |
National Provider Directory
National Provider Directory- Tax ID family
- Presentation Health Sys
Organizations with this tax ID in the same state 24
This tax ID family is large, so up to 24 of its organizations in the same state are linked here.
-
dba Avera McKennan Behavioral Health Services
- Psychiatric Hospital Unit
- Sioux Falls, SD
- NPI 1225201205
-
dba Avera Gregory Dialysis Unit
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Gregory, SD
- NPI 1255435814
-
dba Avera Long Term Care Pharmacy Rapid City
- Long Term Care Pharmacy
- Rapid City, SD
- NPI 1306601794
-
dba Avera 7th Avenue Pharmacy
- Community/Retail Pharmacy
- Sioux Falls, SD
- NPI 1316463219
-
dba Milbank Area Hospital/Avera Health- Swingbed
- Medicare Defined Swing Bed Hospital Unit
- Milbank, SD
- NPI 1326154220
-
dba Avera McKennan Outpatient Therapy Services - Brandon
- Physical Therapy Clinic/Center
- Brandon, SD
- NPI 1346494697
-
dba Avera Medical Group McGreevy Dawley Farm
- Family Medicine Physician
- Sioux Falls, SD
- NPI 1346512266
Locations
1000 E 23rd St
Ste 140
Sioux Falls, SD 57105
Phone (605) 322-3241
Practitioners & affiliated clinicians
Practitioners 27
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Physician Assistant
- Chamberlain, SD
- NPI 1750798039
-
- Physician Assistant
- Sioux Falls, SD
- NPI 1982251203
-
- Cardiovascular Disease Physician
- Sioux Falls, SD
- NPI 1598723603
-
- Family Nurse Practitioner
- Watertown, SD
- NPI 1831403310
-
- Hospitalist Physician
- Sioux Falls, SD
- NPI 1801151170
-
- Family Nurse Practitioner
- Sioux Falls, SD
- NPI 1063083426
-
- Critical Care Medicine (Internal Medicine) Physician
- Sioux Falls, SD
- NPI 1689606303
-
- Physician Assistant
- Sioux Falls, SD
- NPI 1083853162
-
- Orthopaedic Hand Surgery Physician
- Sioux Falls, SD
- NPI 1013993195
-
- Physician Assistant
- Sioux Falls, SD
- NPI 1881112753
-
- Foot & Ankle Surgery Podiatrist
- Sioux Falls, SD
- NPI 1124437595
-
- Orthopaedic Surgery Physician
- Sioux Falls, SD
- NPI 1861615155
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1311292800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1596499200000",
"number": "1356629497",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 86370",
"city": "SIOUX FALLS",
"state": "SD",
"postal_code": "571186370",
"telephone_number": "605-322-7510",
"fax_number": "605-322-6475"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "911 E 20TH ST STE 400",
"city": "SIOUX FALLS",
"state": "SD",
"postal_code": "571051046",
"telephone_number": "605-322-8993",
"fax_number": "605-322-7631"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "AVERA MCKENNAN",
"organizational_subpart": "NO",
"enumeration_date": "2011-07-22",
"last_updated": "2020-08-04",
"certification_date": "2020-08-04",
"status": "A",
"authorized_official_last_name": "FLICEK",
"authorized_official_first_name": "DAVID",
"authorized_official_title_or_position": "CEO/PRESIDENT",
"authorized_official_telephone_number": "605-322-8000"
},
"taxonomies": [
{
"code": "207RH0002X",
"taxonomy_group": "",
"desc": "Internal Medicine, Hospice and Palliative Medicine",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Avera Medical Group Palliative Medicine Sioux Falls",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Avera Medical Group Palliative Medicine Sioux Falls",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Sioux Falls, SD
- Avera McKennan (Avera Medical Group Ear, Nose & Throat)
- Avera McKennan (Avera Medical Group Womens Health Specialists Sioux Falls)
- Avera McKennan (Avera Dermatology)
- Avera McKennan (Avera Specialty Pharmacy)
- Avera McKennan (Avera Medical Group McGreevy Dawley Farm)
- Avera McKennan (Avera Medical Group)
- Avera McKennan (Avera Healthworks)
- Avera McKennan (Avera Medical Group Integrative Medicine Sioux Falls)
- Avera McKennan (Avera Medical Group Pulmonary and Sleep Medicine Sioux Falls)
- Avera McKennan (Avera Endocrinology and Diabetes)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.