SANFORD CLINIC (NPI# 1609895770) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609895770 |
| Entity Type | Organization |
| Organization Name | SANFORD CLINIC |
| Other Organization Name | SANFORD CLINIC TRANSPLANT SERVICES |
| Practice Address |
1205 S. Grange Ave Ste 201 Sioux Falls SD 57105-0414 |
| Mailing Address |
Po Box 5074 Sioux Falls SD 57117-5074 |
| Practice Telephone | 6053289290 |
| Practice Fax Number | 6053289291 |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2020-07-02 |
| Authorized Official Name | TONY LEE MORRISON (VICE PRESIDENT, REVENUE CYCLE) |
| Authorized Official Telephone | 6053288380 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208600000X | Surgery | Allopathic & Osteopathic Physicians | ||
| N | 2086S0129X |
Surgery Specialization: Vascular Surgery |
Allopathic & Osteopathic Physicians | ||
| Y | 204F00000X | Transplant Surgery | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | 281988100 | 05 |
| Other Name | Type Code |
|---|---|
| Sanford Clinic Transplant Services | 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 |
1205 S. GRANGE AVE STE 201 |
| City | SIOUX FALLS |
| State | SD |
| Zip Code | 57105-0414 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235126087 | H. Bruce Vogt | Family Medicine | 1205 S. Grange Ave, Ste 510, Sioux Falls, SD 57105-0410 | 2005-10-05 |
| 1336339357 | Dana Brandys | Internal Medicine | 1205 S. Grange Ave, Ste 201, Sioux Falls, SD 57105-0414 | 2007-07-26 |
| 1295848521 | Sanford Clinic | Internal Medicine | 1205 S. Grange Ave, Ste 201, Sioux Falls, SD 57105-0414 | 2006-08-17 |
| 1801827225 | Sanford Clinic | Obstetrics & Gynecology | 1205 S. Grange Ave, Ste 301, Sioux Falls, SD 57105-0410 | 2006-07-05 |
| 1922053156 | Pamela M Ephgrave | Obstetrics & Gynecology | 1205 S. Grange Ave, Ste 301, Sioux Falls, SD 57105-0410 | 2006-05-24 |
| 1336101849 | Gretchen D Scott | Nurse Practitioner | 1205 S. Grange Ave, Ste 201, Sioux Falls, SD 57105-0414 | 2006-04-03 |
| 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 | 204F00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Transplant Surgery |
| Definition to come. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053546390 | Sujit Vijay Sakpal | Transplant Surgery | 1315 S Cliff Ave Ste 1100, Sioux Falls, SD 57105-1057 | 2009-05-15 |
| 1487610465 | Thavam Chenthan Thambi-pillai | Transplant Surgery | 1508 W 22nd St Ste 101, Sioux Falls, SD 57105-1514 | 2006-04-26 |
| 1043209760 | Jeffery L Steers | Transplant Surgery | 1315 S. Cliff Ave., Ste. 1100, Sioux Falls, SD 57105-1057 | 2005-10-15 |
| 1174716294 | Ali Naji Al-hajjaj | Transplant Surgery | 1315 S. Cliff Ave., Ste. 1100, Sioux Falls, SD 57105-1057 | 2007-08-22 |
| 1962601120 | Ronald Christopher Auvenshine | Transplant Surgery | 1315 S Cliff Ave, Ste 1100, Sioux Falls, SD 57105-1057 | 2007-07-17 |
| 1043228745 | Christine Pocha | Transplant Surgery | 1315 S Cliff Ave, Plaza 3, Sioux Falls, SD 57105-1058 | 2006-08-04 |
| 1730155425 | Avera Mckennan | Transplant Surgery | 1315 S. Cliff Ave., Ste. 1100, Sioux Falls, SD 57105-1057 | 2006-02-23 |
| City | SIOUX FALLS |
| Zip Code | 57105 |
Please comment or provide details below to improve the information on SANFORD CLINIC.
| 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.