AVERA MEDICAL GROUP OPHTHALMOLOGY SIOUX FALLS – NPI #1417246901
Ophthalmology

An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses.

Health Care Provider Taxonomy Code for Ophthalmology

AVERA MEDICAL GROUP OPHTHALMOLOGY SIOUX FALLS is an ophthalmologist located in SIOUX FALLS, SD. NPPES has assigned the NPI number 1417246901 to AVERA MEDICAL GROUP OPHTHALMOLOGY SIOUX FALLS on April 05, 2011. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “AVERA MEDICAL GROUP OPHTHALMOLOGY SIOUX FALLS” is a dba name, the actual legal business name for this organization is AVERA MCKENNAN. This provider is also associated with 2 additional names listed below. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 207W00000X from the Health Care Provider Taxonomy code set, which is classified as Ophthalmology.

The NPI profile was previously updated about 7 years ago on Nov 25, 2019. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for AVERA MEDICAL GROUP OPHTHALMOLOGY SIOUX FALLS below.

NPI Profile for
AVERA MCKENNAN

NPI Number
1417246901
Enumeration Date

(more than 15 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
AVERA MCKENNAN
Doing Business As (dba): AVERA MEDICAL GROUP OPHTHALMOLOGY SIOUX FALLS
Other name(s)
All associated names:
Doing Business As (dba)
Avera Medical Group Eye Care
Doing Business As (dba)
Avera Medical Group Ophthalmology Sioux Falls
Primary location
911 E 20TH ST STE 101
SIOUX FALLS, SD 57105-1043
Phone: (605) 322-3790 Fax: (605) 322-3791
Mailing address
PO BOX 86370
SIOUX FALLS, SD 57118-6370
Phone: (605) 322-7510 Fax:
Organization Subpart
No
Authorized Official
DAVID FLICEK
SENIOR VP OF FINANCE
Phone: (605) 322-7915
Updated
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
207W00000X
- Ophthalmology (Primary)
152W00000X
- Optometrist

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.