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Organization Active NPI

Avera McKennan

Doing business as Avera Medical Group Integrative Medicine Sioux Falls

  • Family Medicine Physician
  • Sioux Falls, SD
National Provider Identifier
1386081883
Registry record updated Oct 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
AVERA MCKENNAN
Doing business as
Avera Medical Group Integrative Medicine Sioux Falls
Practice address
1000 E 23Rd St
Ste. 140
Sioux Falls, SD 57105-2114
Phone
(605) 322-3241
NPI assigned
May 24, 2013
Last updated
Oct 24, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2018

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)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

1000 E 23Rd St
Ste. 140
Sioux Falls, SD 57105-2114

Mailing address

PO Box 86370
Sioux Falls, SD 57118-6370
Phone (605) 322-7510

Other names 1

  • Avera Medical Group Integrative Medicine Sioux Falls Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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 Sys105 organizations share this tax ID, including this one

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.

  • Avera McKennan

    dba Headache Center

    • Neurology Physician
    • Sioux Falls, SD
    • NPI 1295187417
    NPD tax ID
  • Avera McKennan

    dba Avera Flandreau Hospital

    • Critical Access Hospital
    • Flandreau, SD
    • NPI 1295747608
    NPD tax ID
  • Avera McKennan

    dba Avera Long Term Care Pharmacy Rapid City

    • Long Term Care Pharmacy
    • Rapid City, SD
    • NPI 1306601794
    NPD tax ID
  • Avera McKennan

    dba Avera 7th Avenue Pharmacy

    • Community/Retail Pharmacy
    • Sioux Falls, SD
    • NPI 1316463219
    NPD tax ID
  • Avera McKennan

    dba Milbank Area Hospital/Avera Health- Swingbed

    • Medicare Defined Swing Bed Hospital Unit
    • Milbank, SD
    • NPI 1326154220
    NPD tax ID
  • Avera McKennan

    dba Avera Gregory Hospital

    • Physical Therapy Clinic/Center
    • Gregory, SD
    • NPI 1326495409
    NPD tax ID
  • Avera McKennan

    dba Avera Specialty Pharmacy

    • Specialty Pharmacy
    • Sioux Falls, SD
    • NPI 1346266202
    NPD tax ID
  • Avera McKennan

    dba Avera McKennan Outpatient Therapy Services - Brandon

    • Physical Therapy Clinic/Center
    • Brandon, SD
    • NPI 1346494697
    NPD tax ID
  • Avera McKennan

    dba Avera Medical Group McGreevy Dawley Farm

    • Family Medicine Physician
    • Sioux Falls, SD
    • NPI 1346512266
    NPD tax ID
  • Avera McKennan

    dba Avera Medical Group Palliative Medicine Sioux Falls

    • Hospice and Palliative Medicine (Internal Medicine) Physician
    • Sioux Falls, SD
    • NPI 1356629497
    NPD tax ID
  • Avera McKennan

    dba Avera Medical Group Kennebec Area

    • Family Medicine Physician
    • Kennebec, SD
    • NPI 1356788491
    NPD tax ID
  • Avera McKennan

    dba Avera Healthworks

    • Occupational Medicine Clinic/Center
    • Sioux Falls, SD
    • NPI 1376662825
    NPD tax ID
View all 24

Locations

6000 W 41st St
Ste 200
Sioux Falls, SD 57106
Phone (605) 322-1542

Practitioners & affiliated clinicians

Practitioners 15

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.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1369353600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1540339200000",
    "number": "1386081883",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 E 23RD ST",
            "address_2": "STE. 140",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571052114",
            "telephone_number": "605-322-3241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVERA MCKENNAN",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-24",
        "last_updated": "2018-10-24",
        "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": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Avera Medical Group Integrative Medicine Sioux Falls",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Avera Medical Group Integrative Medicine Sioux Falls",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Oct 24, 2018; 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.

Verify at the official NPI Registry.