Basic Information
| Provider Information | |||||||||
| NPI: | 1407891716 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MCKAY | ||||||||
| FirstName: | JENNIFER | ||||||||
| MiddleName: | |||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 86370 | ||||||||
| Address2: | |||||||||
| City: | SIOUX FALLS | ||||||||
| State: | SD | ||||||||
| PostalCode: | 571186370 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6053227510 | ||||||||
| FaxNumber: | 6053226475 | ||||||||
| Practice Location | |||||||||
| Address1: | 1325 S CLIFF AVE | ||||||||
| Address2: | |||||||||
| City: | SIOUX FALLS | ||||||||
| State: | SD | ||||||||
| PostalCode: | 571051007 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6053227905 | ||||||||
| FaxNumber: | 6053228414 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/19/2006 | ||||||||
| LastUpdateDate: | 10/17/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208M00000X | 5189 | SD | Y | Allopathic & Osteopathic Physicians | Hospitalist |
ID Information
| ID | Type | State | Issuer | Description | 6004563 | 05 | SD | MEDICAID | 1566000 | 05 | IA | MEDICAID | 5189 | 01 | SD | DAKOTACARE | OTHER | 0041603 | 01 | SD | SD BLUE CROSS | OTHER | 200960900 | 05 | MN | MEDICAID | 164K0MC | 01 | MN | MN BLUE CROSS BS | OTHER | 46022474331 | 05 | NE | MEDICAID | 6004564 | 05 | SD | MEDICAID | P00068515 | 01 | SD | RR MEDICARE | OTHER | 6004562 | 05 | SD | MEDICAID |