Healthcare Provider Details
I. General information
NPI: 1023080595
Provider Name (Legal Business Name): SARAH A FLYNN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 02/07/2006
Last Update Date: 10/16/2024
Certification Date: 10/16/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2400 W 49TH ST
SIOUX FALLS SD
57105-6581
US
IV. Provider business mailing address
PO BOX 5074
SIOUX FALLS SD
57117-5074
US
V. Phone/Fax
- Phone: 605-312-8700
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084P0804X |
| Taxonomy | Child & Adolescent Psychiatry Physician |
| License Number | 5216 |
| License Number State | SD |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2084P0800X |
| Taxonomy | Psychiatry Physician |
| License Number | 5216 |
| License Number State | SD |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
| # 1 | |
| Identifier | 151K2FL |
| Identifier Type | OTHER |
| Identifier State | MN |
| Identifier Issuer | CC SYSTEMS/ BLUE PLUS |
| # 2 | |
| Identifier | 30471 |
| Identifier Type | OTHER |
| Identifier State | SD |
| Identifier Issuer | SANFORD HEALTH PLANS |
| # 3 | |
| Identifier | 370624200 |
| Identifier Type | OTHER |
| Identifier State | SD |
| Identifier Issuer | DEPT OF LABOR |
| # 4 | |
| Identifier | 57108C019 |
| Identifier Type | OTHER |
| Identifier State | SD |
| Identifier Issuer | WPS TRICARE |
| # 5 | |
| Identifier | 7101770 |
| Identifier Type | MEDICAID |
| Identifier State | SD |
| Identifier Issuer | |
| # 6 | |
| Identifier | 0572016 |
| Identifier Type | MEDICAID |
| Identifier State | IA |
| Identifier Issuer | |
| # 7 | |
| Identifier | 1908622 |
| Identifier Type | OTHER |
| Identifier State | SD |
| Identifier Issuer | ARAZ/ AMERICA'S PPO |
| # 8 | |
| Identifier | 4996036 |
| Identifier Type | OTHER |
| Identifier State | SD |
| Identifier Issuer | BLUE CROSS |
| # 9 | |
| Identifier | 12200 |
| Identifier Type | MEDICAID |
| Identifier State | ND |
| Identifier Issuer | |
| # 10 | |
| Identifier | 240871 |
| Identifier Type | OTHER |
| Identifier State | SD |
| Identifier Issuer | MIDLANDS CHOICE |
| # 11 | |
| Identifier | HP39545 |
| Identifier Type | OTHER |
| Identifier State | SD |
| Identifier Issuer | HEALTHPARTNERS |
| # 12 | |
| Identifier | 983130400 |
| Identifier Type | MEDICAID |
| Identifier State | MN |
| Identifier Issuer | |
| # 13 | |
| Identifier | 46022474352 |
| Identifier Type | MEDICAID |
| Identifier State | NE |
| Identifier Issuer | |
| # 14 | |
| Identifier | 040121002 |
| Identifier Type | OTHER |
| Identifier State | MN |
| Identifier Issuer | PRIMEWEST |
| # 15 | |
| Identifier | 412991034955 |
| Identifier Type | OTHER |
| Identifier State | SD |
| Identifier Issuer | PREFERRED ONE |
| # 16 | |
| Identifier | 5216 |
| Identifier Type | OTHER |
| Identifier State | SD |
| Identifier Issuer | DAKOTACARE |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone:
