Avera McKennan

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Legal business name

AVERA MCKENNAN

Doing business as

Avera Kannan Clinic

Practice address

911 E 20TH St
Ste. 403
Sioux Falls, SD 57105-1042

Phone

(605) 322-7516

Fax

(605) 322-7519

NPI assigned

Feb 7, 2006

Last updated

Mar 27, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Julie N Norton

Title

Senior VP of Finance

Phone

(605) 322-6375

Specialties & licenses 1

Addresses

Other names 1

• Avera Kannan Clinic Doing business as

Medicare fee-for-service enrollment

Enrolled in SD

Enrollment records 1

Locations

Practitioners 2

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.

• Hari D Kannan, M.D.

  • Psychiatry Physician
  • Sioux Falls, SD
  • NPI 1447222906
  NPD (past)
• Patrick M McNeil, LCSW, MSW, QMHP, PIP

  • Clinical Social Worker
  • Sioux Falls, SD
  • NPI 1871565325
  NPD (past)

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

{
    "created_epoch": "1139270400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1332806400000",
    "number": "1609848175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 S MINNESOTA AVE.",
            "address_2": "STE 100",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571053762",
            "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",
            "address_2": "STE. 403",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571051042",
            "telephone_number": "605-322-7516",
            "fax_number": "605-322-7519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVERA MCKENNAN",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-07",
        "last_updated": "2012-03-27",
        "status": "A",
        "authorized_official_last_name": "NORTON",
        "authorized_official_first_name": "JULIE",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "SENIOR VP OF FINANCE",
        "authorized_official_telephone_number": "605-322-6375"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Avera Kannan Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Avera McKennan (Avera McKennan Careflight)
• Avera McKennan (Avera McKennan Hospital and University Health Center)
• Avera McKennan (Avera McKennan Hospital CRNA)
• Avera McKennan
• Avera McKennan (Avera Breast Center Mobile)
• Avera McKennan (Avera McKennan Hospital and University Health Center DME)
• Avera McKennan
• Avera McKennan (Avera Lee Mabee OB/GYN)
• Avera McKennan (Avera Therapy)
• Avera McKennan (Avera McKennan Fitness Center)

• Psychiatry Physician in Sioux Falls, SD
• Providers in Sioux Falls, SD by specialty
• Psychiatry Physician in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2012; 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.