Avera Medical Group Health Care Clinic Sioux Falls

LBN: Avera Mckennan
Avera Medical Group Health Care Clinic Sioux Falls is an health care organization with primary practice located at 300 N Dakota Ave. Ste. 117, Sioux Falls SD 57104-6020. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as the primary health care specialty. Avera Mckennan can be contacted via phone (605) 322-6800, or through Flicek, David via phone (605) 322-8000.

Contact Information

Primary practice address
300 N Dakota Ave. Ste. 117 Sioux Falls SD 57104-6020
Phone: (605) 322-6800
Fax: (605) 322-6802
Website:
Map and Directions
Authorized official contact:
Name: Flicek, David
Phone: (605) 322-8000

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X

Profile Details

NPI number 1083894067
LBN Legal business name Avera Mckennan
DBA Doing business as Avera Medical Group Health Care Clinic Sioux Falls
Authorized official Flicek, David
Entity Organization
Organization subpart 1 No
Enumeration date Nov 7th, 2007
Last updated Oct 24th, 2018 - about 8 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1083894067 NPPES
South Dakota Other 30B74GU BLUE PLUS
South Dakota Other 57105F001 BLUE PLUS
South Dakota MEDICAID 12262 BLUE PLUS
South Dakota Other 0006020 BLUE PLUS
South Dakota MEDICAID 0532341 BLUE PLUS
South Dakota Other 30B74GU BLUE PLUS
South Dakota Other 59767 BLUE PLUS
South Dakota MEDICAID 068417100 BLUE PLUS
South Dakota Other 9251873 BLUE PLUS

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