NPIMap

Individual provider Active NPI

Jessica Powell, PA-C

  • Medical Physician Assistant
  • Sioux Falls, SD
National Provider Identifier
1629550512
Registry record updated Oct 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Practice address
4520 W 69TH St
Sioux Falls, SD 57108-8148
Phone
(605) 977-5000
NPI assigned
Sep 6, 2018
Last updated
Oct 1, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X SD Primary

Addresses

Primary practice location

4520 W 69TH St
Sioux Falls, SD 57108-8148

Mailing address

4520 W 69TH St
Sioux Falls, SD 57108-8148
Phone (605) 977-5000

Other names 1

  • Jessica Powell Former name

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
I20181212003686 SD Practitioner - Physician Assistant 8325383748 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Avera McKennanGroup PAC ID 0345157103, 957 clinicians

Practice addresses (Care Compare)

1101 E Holly Blvd
Brandon, SD 57005-1426
Phone (605) 582-3853

1200 S 7TH Ave
Sioux Falls, SD 57105-0900
Phone (605) 336-2140

4500 W 69TH St
Sioux Falls, SD 57108-8148

4520 W 69TH St
Sioux Falls, SD 57108-8148
Phone (605) 977-5000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Avera McKennan CurrentSince Feb 18, 2019 Accepting new patients
Avera McKennan CurrentSince Feb 18, 2019 Accepting new patients
Heart Hospital of South Dakota LLC Past Accepting new patients
Avera McKennan Past Accepting new patients

Locations

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

4520 W 69th St
Sioux Falls, SD 57108
Phone (605) 977-5000

Interoperability endpoints

  • Direct secure messaging: jessica.powell@avera.sdhealthlink.net

Organizations & group practices 6

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 28

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

View all 28

NPI Registry JSON

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

{
    "created_epoch": "1536192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538352000000",
    "number": "1629550512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4520 W 69TH ST",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571088148",
            "telephone_number": "605-977-5000",
            "fax_number": "605-977-5377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4520 W 69TH ST",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571088148",
            "telephone_number": "605-977-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POWELL",
        "first_name": "JESSICA",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-06",
        "last_updated": "2018-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "SD",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "POWELL",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Sioux Falls, SD

Sources for this page

Verify at the official NPI Registry.