SANFORD CLINIC (NPI# 1073529483) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073529483 |
| Entity Type | Organization |
| Organization Name | SANFORD CLINIC |
| Other Organization Name | SANFORD CLINIC ASTHMA, ALLERGY & IMMUNOLOGY |
| Practice Address |
2701 S Kiwanis Ave Sioux Falls SD 57105-4252 |
| Mailing Address |
Po Box 5074 Sioux Falls SD 57117-5074 |
| Practice Telephone | 6053289180 |
| Practice Fax Number | 6053289101 |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2019-11-23 |
| Authorized Official Name | STEVE GOETSCH (CFO) |
| Authorized Official Telephone | 6053286940 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207K00000X | Allergy & Immunology | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IA | 0537886 | 05 | |
| MN | 281988100 | 05 |
| Other Name | Type Code |
|---|---|
| Sanford Clinic Asthma, Allergy & Immunology | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164069506 | Sanford Clinic | Clinic/Center | 2310 S Marion Rd Ste 140, Sioux Falls, SD 57106-1144 | 2019-12-04 |
| 1457995714 | Sanford Clinic | Clinic/Center | 1112 S Lake Ave, Ste 201, Sioux Falls, SD 57104 | 2019-10-30 |
| 1356983175 | Sanford Clinic | Clinic/Center | 366 Hillsboro Technology Dr, Deerfield Beach, FL 33441-1836 | 2019-10-14 |
| 1427555002 | Sanford Clinic | Family Medicine | 136 S Phillips Ave Ste 102, Sioux Falls, SD 57104 | 2018-04-10 |
| 1396089900 | Sanford Clinic | Nurse Practitioner | 1309 W 17th St Ste 102, Sioux Falls, SD 57104-4663 | 2012-11-20 |
| 1740416395 | Sanford Clinic | Pediatrics | 2502 W. Elk Ave., Duncan, OK 73533 | 2009-06-09 |
| 1861685166 | Sanford Clinic | Radiology | 891 14th Ave Ne, Watertown, SD 57201 | 2007-08-21 |
| 1366635740 | Sanford Clinic | Family Medicine | 433 Kansas Ave Se, Huron, SD 57350-2561 | 2007-08-20 |
| 1922123108 | Sanford Clinic | Clinic/Center | 703 S Broadway, Watertown, SD 57201 | 2007-03-20 |
| 1285738997 | Sanford Clinic | Obstetrics & Gynecology | 1201 S Euclid Ave Ste 201, Sioux Falls, SD 57105-0434 | 2006-09-12 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | SANFORD CLINIC | 1305 W 18th St, Sioux Falls, SD 57105-0401 |
| Colorado Business Entities | Sanford Clinic | 1305 W 18th St, Sioux Falls, SD 57105 |
| Iowa Business Entities | SANFORD CLINIC | 1305 W 18th St, Sioux Falls, SD 57105 |
| Oklahoma Business Registrations | SANFORD CLINIC | 1305 W 18th St, Sioux Falls, SD 57105 |
| Iowa Business Entities | SANFORD CLINIC NORTH | 801 Broadway North, Fargo, ND 58122 |
| System for Award Management (SAM) Entities | SANFORD CLINIC NORTH FARGO | 801 Broadway N, Fargo, ND 58102-3641 |
| Street Address |
2701 S KIWANIS AVE |
| City | SIOUX FALLS |
| State | SD |
| Zip Code | 57105-4252 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972597235 | Susan M Anderson | Family Medicine | 2701 S Kiwanis Ave, Sioux Falls, SD 57105-4252 | 2005-09-01 |
| 1760992192 | Alicia Daum | Physician Assistant | 2701 S Kiwanis Ave, Sioux Falls, SD 57105-4252 | 2017-10-12 |
| 1720432073 | Adeem Abdulwahab | Family Medicine | 2701 S Kiwanis Ave, Sioux Falls, SD 57105-4252 | 2016-04-22 |
| 1629469374 | Paige Anderson | Counselor | 2701 S Kiwanis Ave, Sioux Falls, SD 57105-4252 | 2015-02-16 |
| 1053575092 | Wendy Ann Vetter | Internal Medicine | 2701 S Kiwanis Ave, Sioux Falls, SD 57105-4252 | 2008-07-17 |
| 1093997017 | Sanford Clinic | Family Medicine | 2701 S Kiwanis Ave, Sioux Falls, SD 57105-4252 | 2007-11-30 |
| 1972644136 | Marybeth Vilhauer | Physical Therapist | 2701 S Kiwanis Ave, Sioux Falls, SD 57105-4252 | 2007-02-09 |
| 1013010081 | Mark Nelson Beard | Emergency Medicine | 2701 S Kiwanis Ave, Sioux Falls, SD 57105-4252 | 2006-09-06 |
| 1326054784 | Sanford Clinic | Family Medicine | 2701 S Kiwanis Ave, Sioux Falls, SD 57105-4252 | 2006-07-31 |
| 1912913351 | Sanford Clinic | Family Medicine | 2701 S Kiwanis Ave, Sioux Falls, SD 57105-4252 | 2006-07-31 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871117549 | Ashlesha Ravindra Bagwe | Student in an Organized Health Care Education/Training Program | Pediatrics Residency Program, 1305 W 18th St, Rt 6364, Sioux Falls, SD 57105 | 2020-05-29 |
| 1306494489 | Kelsey Elaine Kruse | Counselor | 3101 West 41st, Sioux Falls, SD 57105 | 2019-08-30 |
| 1902388341 | Sarah Tacke | Nurse Practitioner | 1301 West 18th Street, Sioux Falls, SD 57105 | 2018-09-02 |
| 1235624727 | Mahum Shahid | Student in an Organized Health Care Education/Training Program | 1400 W. 22nd St, Sioux Falls, SD 57105 | 2018-06-27 |
| 1942790126 | Smitha Narayana Gowda | Student in an Organized Health Care Education/Training Program | 1400 22nd Street, Sioux Falls, SD 57105 | 2018-05-14 |
| 1326538554 | Mali Elizabeth Teller | Speech-Language Pathologist | 2501 W. 26th Street, Sioux Falls, SD 57105 | 2018-05-14 |
| 1871081505 | Abdelmohaymin Abdalla Abufatima Abdalla | Student in an Organized Health Care Education/Training Program | Usd-ssom-internal Medicine Residency, 1400 22nd Street, Sioux Falls, SD 57105 | 2018-04-27 |
| 1710474697 | Moataz Ellithi | Student in an Organized Health Care Education/Training Program | 1400 W. 22nd St., Sioux Falls, SD 57105 | 2018-04-17 |
| 1366948663 | Holly Ahlers | Registered Nurse | 2000 S. Summit Ave, Sioux Falls, Sd 57105, Sioux Falls, SD 57105 | 2018-04-04 |
| 1558864124 | Darcy Lee Jensen | Counselor | 822 East 41st. Street, Suite 235, Souix Falls, SD 57105 | 2018-03-09 |
| Find all providers in zip 57105 | ||||
| Taxonomy Code | 207K00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Allergy & Immunology |
| An allergist-immunologist is trained in evaluation, physical and laboratory diagnosis, and management of disorders involving the immune system. Selected examples of such conditions include asthma, anaphylaxis, rhinitis, eczema, and adverse reactions to drugs, foods, and insect stings as well as immune deficiency diseases (both acquired and congenital), defects in host defense, and problems related to autoimmune disease, organ transplantation, or malignancies of the immune system. |
| Notes: Source: American Board of Medical Specialties, 2007, www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Allergy and Immunology, 2007. http://www.abai.org/ No subspecialty certificates in allergy and immunology are offered by the American Board of Allergy and Immunology (ABAI). The ABAI, however, does offer formal special pathways for physicians seeking dual certification in allergy/immunology and pediatric pulmonology; allergy/immunology and pediatric rheumatology; and allergy/immunology and adult rheumatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932468154 | Brennan Allergy Clinic Prof LLC | Allergy & Immunology | 5009 S Bur Oak Pl, Sioux Falls, SD 57108-2228 | 2012-05-08 |
| 1801030135 | Nikki Patel | Allergy & Immunology | 2601 S Ellis Rd, Sioux Falls, SD 57106-7067 | 2009-04-30 |
| 1205830072 | Thomas M. Wilson | Allergy & Immunology | 2701 S Kiwanis Ave, Sioux Falls, SD 57105-4252 | 2005-06-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487067385 | Robert C. Stelzle Md | Allergy & Immunology | 101 E Minnesota St, Suite 240, Rapid City, SD 57701-7757 | 2014-06-09 |
| 1467721407 | Farah Khan | Allergy & Immunology | 101 E Minnesota St, Rapid City, SD 57701-7756 | 2011-12-20 |
| 1578882387 | Aberdeen Asthma & Allergy PC | Allergy & Immunology | 201 S Lloyd St, W190, Aberdeen, SD 57401-4552 | 2010-05-19 |
| 1578595096 | Thomas Langworthy Luzier | Allergy & Immunology | 201 S Lloyd St, W190, Aberdeen, SD 57401-4552 | 2006-07-07 |
| City | SIOUX FALLS |
| Zip Code | 57105 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.