SANFORD CLINIC NORTH (NPI# 1255348280) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255348280 |
| Entity Type | Organization |
| Organization Name | SANFORD CLINIC NORTH |
| Other Organization Name | SANFORD HEALTH LIDGERWOOD CLINIC |
| Practice Address |
21 Wiley Avenue South Lidgerwood ND 58053-4001 |
| Mailing Address |
720 Fourth Street S Fargo ND 58122-0605 |
| Practice Telephone | 7015384189 |
| Practice Fax Number | 7015384319 |
| Mailing Telephone | 7012342000 |
| Enumeration Date | 2006-08-02 |
| Last Update Date | 2019-11-21 |
| Authorized Official Name | MARTHA K LECLERC (VP) |
| Authorized Official Telephone | 7012346248 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR1300X |
Clinic/Center Specialization: Rural Health |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ND | 5135 | 05 | |
| ND | 12857 | 05 | |
| ND | BLUE SHIELD | 1327001 | 01 |
| ND | RAILROAD MEDICARE | CF8850 | 01 |
| Other Name | Type Code |
|---|---|
| Sanford Health Lidgerwood Clinic | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477042372 | Sanford Clinic North | Pharmacy | 1611 Anne St Nw Ste 1, Bemidji, MN 56601-5114 | 2018-05-07 |
| 1386099026 | Sanford Clinic North | Clinic/Center | 625 Demers Ave, East Grand Forks, MN 56721-1833 | 2016-05-02 |
| 1922361716 | Sanford Clinic North | Internal Medicine | 2960 Seter Pkwy, Fargo, ND 58104-8692 | 2012-06-18 |
| 1922303213 | Sanford Clinic North | Clinic/Center | 1245 Washington Avenue, Detroit Lakes, MN 56501-3905 | 2011-01-18 |
| 1437355393 | Sanford Clinic North | Family Medicine | 929 Central Avenue, East Grand Forks, MN 56721 | 2007-06-26 |
| 1124122783 | Sanford Clinic North | Durable Medical Equipment & Medical Supplies | 4000 28th Ave S, Moorhead, MN 56560 | 2006-09-12 |
| 1679677124 | Sanford Clinic North | Durable Medical Equipment & Medical Supplies | 1233 34th St Nw Ste C, Bemidji, MN 56601 | 2006-09-12 |
| 1073520003 | Sanford Clinic North | Clinic/Center | 336 Main Street, Forman, ND 58032-0184 | 2006-08-02 |
| 1164439196 | Sanford Clinic North | Clinic/Center | 100 1st Avenue Sw, Suite 2, Lamoure, ND 58458-7311 | 2006-08-02 |
| 1780690305 | Sanford Clinic North | Clinic/Center | 69 Highway 13 W, Gwinner, ND 58040-4127 | 2006-08-01 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| 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 |
21 WILEY AVENUE SOUTH |
| City | LIDGERWOOD |
| State | ND |
| Zip Code | 58053-4001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619986601 | Southeast Therapy Services Inc | Clinic/Center | 21 Wiley Avenue South, Lidgerwood, ND 58053-4001 | 2006-08-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013524438 | Dakota Estates Incorporated | In Home Supportive Care | 440 Wiley Ave. S., Lidgerwood, ND 58053 | 2020-09-29 |
| 1669917308 | Northcreek Dental PC | Dentist | 19 Wiley Ave, Lidgewood, ND 58053 | 2017-01-05 |
| 1295896934 | Lidgerwood Rural Ambulance Service | Ambulance | 146 Wiley Ave S, Lidgerwood, ND 58053 | 2006-12-13 |
| 1962706184 | Breanna Noelle Bischoff | Chiropractor | 22 Wiley Ave., Lidgerwood, ND 58053-0087 | 2011-01-03 |
| 1265789150 | Breanna Bischoff PC | Chiropractor | 22 Wiley Ave., Lidgerwood, ND 58053-0087 | 2012-08-09 |
| 1376692756 | James D Marotzke | Dentist | 19 Wiley Ave. S., Lidgerwood, ND 58053-0431 | 2007-01-09 |
| 1285043802 | Lidgerwood Dental Office | Clinic/Center | 19 Wiley Ave S, Lidgerwood, ND 58053-4001 | 2014-08-07 |
| 1982679650 | Jeffrey Scott Hedlund | Physician Assistant | 21 Wiley Ave S, Lidgerwood, ND 58053-4001 | 2006-02-17 |
| 1669071403 | Sandra Jean Borgen | Technician | 110 1st Ave Se, Lidgerwood, ND 58053-4200 | 2020-10-22 |
| 1457999252 | Kelly Honl | Speech-Language Pathologist | 28 3rd Ave Se, Lidgerwood, ND 58053-4206 | 2019-12-12 |
| Find all providers in zip 58053 | ||||
| Taxonomy Code | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457963274 | Nelson County Health System | Clinic/Center | 115 South St E, Michigan, ND 58259-4120 | 2020-08-21 |
| 1821637828 | Christian Unity Hospital Corporation | Clinic/Center | 503 Park St W Ste B, Park River, ND 58270-4138 | 2019-12-23 |
| 1023550118 | Northwood Deaconess Health Center | Clinic/Center | 308 Whinery Street, Binford, ND 58416 | 2016-11-07 |
| 1689085797 | Northwood Deaconess Health Center | Clinic/Center | 611 Towner Ave, Larimore, ND 58251 | 2014-05-12 |
| 1043649486 | Jacobson Memorial Hospital Care Center | Clinic/Center | 215 3rd Ave W, Richardton, ND 58652-7109 | 2013-11-06 |
| 1700064599 | Rolla Eye Clinic | Clinic/Center | 118 3rd St. Ne, Rolla, ND 58367-1170 | 2008-02-05 |
| 1891859948 | Nelson County Health System | Clinic/Center | 117 2nd St West, Lakota, ND 58344 | 2006-12-21 |
| 1760570394 | West River Health Services | Clinic/Center | 211 Main Street, Scranton, ND 58653 | 2006-10-10 |
| 1942398508 | West River Health Services | Clinic/Center | 420 Pacific Ave, Mott, ND 58646 | 2006-10-10 |
| 1871691519 | Jacobson Memorial Hospital Care Center | Clinic/Center | 603 East St N, Elgin, ND 58533-7105 | 2006-09-20 |
| Find all providers with the same taxonomy | ||||
| City | LIDGERWOOD |
| Zip Code | 58053 |
Please comment or provide details below to improve the information on SANFORD CLINIC NORTH.
| 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.