SANFORD MEDICAL CENTER FARGO (NPI# 1114207453) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114207453 |
| Entity Type | Organization |
| Organization Name | SANFORD MEDICAL CENTER FARGO |
| Other Organization Name | SANFORD HEALTH VALLEY CITY CLINIC |
| Practice Address |
520 Chautauqua Blvd Valley City ND 58072-3145 |
| Practice Telephone | 7018456000 |
| Mailing Telephone | 7018456000 |
| Enumeration Date | 2011-08-18 |
| Last Update Date | 2019-09-09 |
| Authorized Official Name | MARTHA LECLERC (VICE PRESIDENT) |
| Authorized Official Telephone | 7012346248 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| Y | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Sanford Health Valley City Clinic | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245519081 | Sanford Medical Center Fargo | General Acute Care Hospital | 2990 Seter Parkway, Fargo, ND 58104-8750 | 2011-08-10 |
| 1558458844 | Sanford Medical Center Fargo | Pharmacy | 1720 S University Drive, Fargo, ND 58103-4940 | 2006-10-06 |
| 1578508198 | Sanford Medical Center Fargo | Clinic/Center | 1234 Washington Ave Ste B, Detroit Lakes, MN 56501-3906 | 2006-06-18 |
| 1225635634 | Sanford Medical Center Fargo | Pharmacy | 1720 University Dr S, Fargo, ND 58103-4940 | 2020-10-08 |
| 1174120281 | Sanford Medical Center Fargo | Pharmacy | 5225 23rd Ave S, Fargo, ND 58104-7927 | 2020-10-02 |
| 1013559905 | Sanford Medical Center Fargo | Hospice Care, Community Based | 801 Broadway N, Fargo, ND 58102-3641 | 2019-10-11 |
| 1366092801 | Sanford Medical Center Fargo | Hospice Care, Community Based | 820 4th St N, Fargo, ND 58102-4539 | 2019-09-17 |
| 1861927709 | Sanford Medical Center Fargo | Pharmacy | 5225 23rd Ave S, Fargo, ND 58104 | 2017-04-28 |
| 1801151394 | Sanford Medical Center Fargo | Clinic/Center | 2400 32nd Ave S, Fargo, ND 58103-5800 | 2012-07-10 |
| 1366717118 | Sanford Medical Center Fargo | Clinic/Center | 1245 Washington Ave, Detroit Lakes, MN 56501-3905 | 2012-03-13 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | SANFORD MEDICAL CENTER FARGO | 720 N 4th St, Fargo, ND 58122-4520 |
| Street Address |
520 CHAUTAUQUA BLVD |
| City | VALLEY CITY |
| State | ND |
| Zip Code | 58072-3145 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144262858 | Sanford Clinic North | Family Medicine | 520 Chautauqua Blvd, Valley City, ND 58072-3145 | 2006-06-10 |
| 1982109930 | Amy Beth Tahran | Counselor | 520 Chautauqua Blvd, Valley City, ND 58072 | 2018-03-29 |
| 1932621414 | Ashley M Horner | Family Medicine | 520 Chautauqua Blvd, Valley City, ND 58072-3145 | 2017-07-17 |
| 1558807289 | Antonia Popo | Social Worker | 520 Chautauqua Blvd, Valley City, ND 58072-3145 | 2017-01-19 |
| 1215393657 | Jessica Gower | Physician Assistant | 520 Chautauqua Blvd, Valley City, ND 58072-3145 | 2016-01-14 |
| 1073825089 | Judy L Anderson | Physician Assistant | 520 Chautauqua Blvd, Valley City, ND 58072-3145 | 2010-07-07 |
| 1417109760 | Misty Kay Anderson | Internal Medicine | 520 Chautauqua Blvd, Valley City, ND 58072-3145 | 2008-10-17 |
| 1669583183 | David L Hochhalter | Family Medicine | 520 Chautauqua Blvd, Valley City, ND 58072-3145 | 2006-08-31 |
| 1851314942 | Glenn M Thoreson | Family Medicine | 520 Chautauqua Blvd, Valley City, ND 58072-3145 | 2006-07-26 |
| 1649291865 | Joan Lefor Stoltz | Physician Assistant | 520 Chautauqua Blvd, Valley City, ND 58072-3145 | 2006-07-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376063693 | Casey Skramstad | Adult Companion | 943 13th Ave Sw, Valley City, ND 58072 | 2017-06-27 |
| 1750656310 | Scott Mcneal | Specialist | 1028 West Main St, Valley City, ND 58072 | 2012-03-15 |
| 1447560164 | Lemont William Jahn | Pharmacist | 148 S Central Avenue, Valley City, ND 58072 | 2010-10-15 |
| 1104000124 | Janice Kay Gabriel Johnson | Occupational Therapist | 136 2nd Ave Ne, Valley City, ND 58072 | 2007-12-27 |
| 1194926659 | Barnes County Ambulance Inc | Emergency Medical Technician, Paramedic | 914 11th Ave Sw, Valley City, ND 58072 | 2007-05-30 |
| 1649332461 | Craig A Wagamon | Nurse Anesthetist, Certified Registered | 206 8th St Nw, Valley City, ND 58072 | 2006-12-15 |
| 1235204389 | Open Door Center | Intermediate Care Facility, Mentally Retarded | 209 2nd Street Se, Valley City, ND 58072 | 2006-11-22 |
| 1215001706 | Barbara E Owen | Speech-Language Pathologist | Sheyenne Care Center, 979 No Central Ave, Valley City, ND 58072 | 2006-11-17 |
| 1891877239 | Central Avenue Chiropractic PC | Chiropractor | 323 Central Avenue North, Suite 202, Valley City, ND 58072 | 2006-10-19 |
| 1831271287 | Larry Edwin Sayler | Chiropractor | 323 North Central Avenue, Suite 202, Valley City, ND 58072 | 2006-10-19 |
| Find all providers in zip 58072 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417109760 | Misty Kay Anderson | Internal Medicine | 520 Chautauqua Blvd, Valley City, ND 58072-3145 | 2008-10-17 |
| 1184641854 | Madeline Z Luke | Internal Medicine | 520 Chautauqua Blvd, Valley City, ND 58072-3145 | 2006-07-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184142747 | Kayla Estepp | Internal Medicine | 737 Broadway North, Fargo, ND 58122 | 2017-09-05 |
| 1780118331 | Stephanie Melquist | Internal Medicine | Internal Medicine Resident Clinic, 801 N Broadway, Fargo, ND 58102 | 2017-04-19 |
| 1700238714 | Youstina Michael | Internal Medicine | 408 Roberts St N Apt 208, Fargo, ND 58102-4599 | 2016-07-01 |
| 1164834289 | Joshua Jost | Internal Medicine | Broadway N, 801, Fargo, ND 58122-0170 | 2014-05-22 |
| 1659782258 | Sarah Fanai | Internal Medicine | Sanford Health, 801 Broadway North, Fargo, ND 58122-0170 | 2014-05-16 |
| 1376963520 | Total Transformation Clinic, PC | Internal Medicine | 317 16th St Nw, Minot, ND 58703-2919 | 2014-04-25 |
| 1447696406 | Mohamad Imam | Internal Medicine | 801 Broadway North, Fargo, ND 58122 | 2013-05-17 |
| 1316383383 | Janya Swami | Internal Medicine | Sanford Health System 801 Broadway N, Fargo, ND 58122-0170 | 2013-05-17 |
| 1922361716 | Sanford Clinic North | Internal Medicine | 2960 Seter Pkwy, Fargo, ND 58104-8692 | 2012-06-18 |
| 1912273418 | Eric Priyakumar Ragland | Internal Medicine | Essentia Health, 3000 32nd Ave S, Fargo, ND 58104 | 2012-03-29 |
| Find all providers with the same taxonomy | ||||
| City | VALLEY CITY |
| Zip Code | 58072 |
Please comment or provide details below to improve the information on SANFORD MEDICAL CENTER FARGO.
| 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.