Avera Medical Group Midwest Psychiatric Medicine Sioux Falls

LBN: Avera Mckennan
Avera Medical Group Midwest Psychiatric Medicine Sioux Falls is an health care organization with primary practice located at 4400 W 69Th St Ste 500, Sioux Falls SD 57108. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Psychiatry, which is considered as the primary health care specialty. Avera Mckennan can be contacted via phone (605) 322-7580, or through Flicek, David via phone (605) 322-8000.

Contact Information

Primary practice address
4400 W 69Th St Ste 500 Sioux Falls SD 57108
Fax: (605) 322-7579
Website:
Authorized official contact:
Name: Flicek, David

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X

Profile Details

NPI number 1407829781
LBN Legal business name Avera Mckennan
DBA Doing business as Avera Medical Group Midwest Psychiatric Medicine Sioux Falls
Authorized official Flicek, David
Entity Organization
Organization subpart 1 No
Enumeration date Feb 8th, 2006
Last updated Oct 24th, 2018 - about 6 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 1407829781 NPPES
South Dakota Other 370624200 DEPT OF LABOR
South Dakota Other 3T021SC DEPT OF LABOR
South Dakota Other 65742 DEPT OF LABOR
South Dakota MEDICAID 293011100 DEPT OF LABOR
South Dakota Other 0006118 DEPT OF LABOR
South Dakota Other 92411422904 DEPT OF LABOR
South Dakota MEDICAID 0211607 DEPT OF LABOR

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