Organization Active NPI

Kannan Clinic, P.C.

  • Psychiatry Physician
  • Sioux Falls, SD
National Provider Identifier
1982640892
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
3486 Issued in SD
Legal business name
KANNAN CLINIC, P.C.
Practice address
5120 S Western Ave
Ste. 104
Sioux Falls, SD 57108-5013
Phone
(605) 271-3900
Fax
(605) 271-3902
NPI assigned
Jun 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Hari Dasan Kannan, M.D.NPI 1447222906
Title
Owner/Psychiatrist
Phone
(605) 728-1902

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X 3486 SD Primary

Addresses

Primary practice location

5120 S Western Ave
Ste. 104
Sioux Falls, SD 57108-5013

Mailing address

5120 S Western Ave
Ste. 104
Sioux Falls, SD 57108-5013
Phone (605) 271-3900

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060804000156 SD Part B Supplier - Clinic/Group Practice 3779586060 Receives reassigned benefits from 1 practitioner
Practice locations: Sioux Falls, SD

National Provider Directory

National Provider Directory

Locations

5120 S Western Ave
Sioux Falls, SD 57108
Phone (605) 221-0270

6709 S Minnesota Ave
Ste 202
Sioux Falls, SD 57108
Phone (605) 271-3900

5120 S Western Ave
Ste 104
Sioux Falls, SD 57108
Phone (605) 271-3900

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1150761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1982640892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5120 S WESTERN AVE",
            "address_2": "STE. 104",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571085013",
            "telephone_number": "605-271-3900",
            "fax_number": "605-271-3902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5120 S WESTERN AVE",
            "address_2": "STE. 104",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571085013",
            "telephone_number": "605-271-3900",
            "fax_number": "605-271-3902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KANNAN CLINIC, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KANNAN",
        "authorized_official_first_name": "HARI",
        "authorized_official_middle_name": "DASAN",
        "authorized_official_title_or_position": "OWNER/PSYCHIATRIST",
        "authorized_official_telephone_number": "605-728-1902",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "SD",
            "license": "3486",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Aug 22, 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.

Verify at the official NPI Registry.