AVERA MEDICAL GROUP FUNCTIONAL MEDICINE
NPI 1255307450
Nurse Practitioner - Women's Health in Sioux Falls, SD
About Avera Medical Group Functional Medicine NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
AVERA MEDICAL GROUP FUNCTIONAL MEDICINE (NPI 1255307450) is a healthcare organization registered as a women's health in Sioux Falls, South Dakota and active in the NPI registry since February 2006. The organization lists David Flicek, Ceo/president, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Other Identifiers 9
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Avera Medical Group Functional Medicine is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
1,275Medicare enrollment records show 1,275 clinicians reassign Medicare billing to Avera Medical Group Functional Medicine, which bills Medicare for the services they deliver. Of these, 21 practice at this address and 762 within 10 miles. Listed here are the 20 practicing nearest to this location.
Clinicians by Medicare Specialty 59
Nearest to this location (20)
See all 1,275Sioux Falls, SD 57105
Sioux Falls, SD 57105
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Avera Mckennan's NPI number?
The NPI number for Avera Mckennan is 1255307450. It was assigned to this organization in the NPPES registry on February 27, 2006. The provider is doing business as Avera Medical Group Functional Medicine.
Where is Avera Mckennan located?
Avera Mckennan is located at 911 E 20th St Ste 200, Sioux Falls, SD 57105. The listed phone number is (605) 322-3455.
What is Avera Mckennan's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Women's Health, with taxonomy code 363LW0102X.
Is Avera Mckennan enrolled in Medicare?
Yes. Avera Mckennan is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Avera Mckennan?
According to the CMS Revalidation Reassignment List (October 2026 release), 1,275 clinicians in 59 Medicare specialties reassign their Medicare billing to Avera Mckennan. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (268), Certified Registered Nurse Anesthetist (CRNA) (115) and Internal Medicine (108). Of these, 21 practice at this address and 762 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Avera Mckennan was last updated on February 16, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Avera Medical Group Functional Medicine · NPI 1255307450
Women's Health organization in Sioux Falls, South Dakota. Organization record, active in the CMS NPPES registry since February 27, 2006.
## Identity
- **NPI:** 1255307450 (Entity type: Organization)
- **Enumerated:** February 27, 2006
- **Primary specialty:** Nurse Practitioner - Women's Health · taxonomy 363LW0102X
- **Legal business name:** Avera Mckennan
- **Organization subpart:** No
- **Authorized official:** David Flicek, CEO/PRESIDENT
## Practice location
- **Address:** 911 E 20TH ST, STE 200, Sioux Falls, SD 57105-1042
- **Phone:** (605) 322-3455 · **Fax:** (605) 322-3456
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1,275 clinicians in 59 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (268), Certified Registered Nurse Anesthetist (CRNA) (115), Internal Medicine (108); 21 practice at this address and 762 within 10 miles; [full list](https://npiprofile.com/npi/1255307450/clinicians) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** February 16, 2021
- **Other identifiers:** Medicaid 0748939 (IA); Other 9177384 (SD); Medicaid 10025120100 (NE); and 6 more
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Source: [NPI Profile](https://npiprofile.com/npi/1255307450) · Data from the CMS NPPES public registry.