SANFORD CLINIC (NPI# 1639126402) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639126402 |
| Entity Type | Organization |
| Organization Name | SANFORD CLINIC |
| Other Organization Name | SANFORD CLINIC BAKER SPECIALTY ORTHOPEDICS |
| Practice Address |
1210 W 18th St Sioux Falls SD 57104-4647 |
| Practice Telephone | 6053283999 |
| Practice Fax Number | 6053282867 |
| Mailing Telephone | 6053283999 |
| Mailing Fax Number | 6053282867 |
| Enumeration Date | 2006-05-27 |
| Last Update Date | 2019-11-25 |
| Authorized Official Name | STEVE GOETSCH (CFO) |
| Authorized Official Telephone | 6053286940 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207XS0106X |
Orthopaedic Surgery Specialization: Hand Surgery |
Allopathic & Osteopathic Physicians | ||
| N | 207XS0114X |
Orthopaedic Surgery Specialization: Adult Reconstructive Orthopaedic Surgery |
Allopathic & Osteopathic Physicians | ||
| N | 207XX0004X |
Orthopaedic Surgery Specialization: Foot and Ankle Surgery |
Allopathic & Osteopathic Physicians | ||
| N | 207XX0005X |
Orthopaedic Surgery Specialization: Sports Medicine |
Allopathic & Osteopathic Physicians | ||
| N | 207XX0801X |
Orthopaedic Surgery Specialization: Orthopaedic Trauma |
Allopathic & Osteopathic Physicians | ||
| Y | 207X00000X | Orthopaedic Surgery | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | 684424300 | 05 |
| Other Name | Type Code |
|---|---|
| Sanford Clinic Baker Specialty Orthopedics | 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 |
1210 W 18TH ST |
| City | SIOUX FALLS |
| State | SD |
| Zip Code | 57104-4647 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043216955 | John Elmer Forrette Jr. | Podiatrist | 1210 W 18th St, Sioux Falls, SD 57104-4647 | 2005-06-24 |
| 1437701570 | April E Labat | Nurse Practitioner | 1210 W 18th St, Sioux Falls, SD 57104-4647 | 2019-07-09 |
| 1245731728 | Jonathan Sorensen | Nurse Practitioner | 1210 W 18th St, Sioux Falls, SD 57104-4647 | 2018-02-21 |
| 1639610116 | Krystal Niesen | Physician Assistant | 1210 W 18th St, Suite G01, Sioux Falls, SD 57104-4647 | 2017-03-16 |
| 1811433709 | Marie Hansen | Physician Assistant | 1210 W 18th St, Suite G01, Sioux Falls, SD 57104-4647 | 2017-01-16 |
| 1952843054 | Megan Marie Weston | Nurse Practitioner | 1210 W 18th St, Suite 100, Sioux Falls, SD 57104-4647 | 2016-11-07 |
| 1497203780 | Stacy Eden | Nurse Practitioner | 1210 W 18th St, Sioux Falls, SD 57104-4647 | 2016-09-14 |
| 1689021537 | Christopher De Berg | Nurse Practitioner | 1210 W 18th St, Suite G01, Sioux Falls, SD 57104-4651 | 2016-05-20 |
| 1902285463 | Caleb Richard Blauwet | Physician Assistant | 1210 W 18th St, Suite G01, Sioux Falls, SD 57104-4647 | 2015-05-29 |
| 1144613803 | Joanne Gunderson | Nurse Practitioner | 1210 W 18th St, Ste 100, Sioux Falls, SD 57104-9890 | 2015-03-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518594134 | Melissa Bader | Nurse Practitioner | 1112 S. Lake Ave, Suite 201, Sioux Falls, SD 57104 | 2020-03-24 |
| 1457995714 | Sanford Clinic | Clinic/Center | 1112 S Lake Ave, Ste 201, Sioux Falls, SD 57104 | 2019-10-30 |
| 1427555002 | Sanford Clinic | Family Medicine | 136 S Phillips Ave Ste 102, Sioux Falls, SD 57104 | 2018-04-10 |
| 1033637210 | Anna Peasley | Speech-Language Pathologist | 710 W 18th St, Sioux Falls, SD 57104 | 2017-09-07 |
| 1699204313 | Sioux Falls Primary Home Care Services LLC | In Home Supportive Care | 201 N Minnesota Ave Ste 101l, Sioux Falls, SD 57104 | 2017-06-06 |
| 1093258808 | Megan Regina Wexler | Social Worker | 4510 N Lewis Ave, Sioux Falls, SD 57104 | 2016-11-28 |
| 1831645498 | Ryan Ortiz | Specialist/Technologist | 1908 1/2 Old Town Rd Nw, Albuquerque, NM 57104 | 2016-09-01 |
| 1881140622 | Kristine Carol Smith | Occupational Therapist | 601 N. Spring Ave, Hawthorne Elementary, Sioux Falls, SD 57104 | 2016-08-31 |
| 1215299292 | Jolene Mitchell | Preventive Medicine | 900 E 54th St N Ste 100, Sioux Falls, SD 57104 | 2012-06-14 |
| 1871874651 | Christine Marie Burg | Pharmacist | 2503 East 54th Street N., Medvantx Pharmacy Services, Sioux Falls, SD 57104 | 2011-09-07 |
| Find all providers in zip 57104 | ||||
| Taxonomy Code | 207X00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. American Osteopathic Board of Orthopaedic Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Orthopaedic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598325375 | Osd Care of Sd, LLC | Orthopaedic Surgery | 519 W 22nd St Ste 100, Sioux Falls, SD 57105-1745 | 2019-06-14 |
| 1982821898 | Michael Coale Devish | Orthopaedic Surgery | 6100 S Louise Ave Ste 2100, Sioux Falls, SD 57108-6021 | 2007-04-20 |
| 1861615155 | Patrick Mark O'brien | Orthopaedic Surgery | 911 E 20th St Ste 300, Sioux Falls, SD 57105-1045 | 2007-04-11 |
| 1144232042 | Travis Richard Liddell | Orthopaedic Surgery | 2908 E. 26th St., Sioux Falls, SD 57103-4034 | 2006-08-12 |
| 1679524805 | Thomas A Ambrose II | Orthopaedic Surgery | 911 E. 20th St., Ste. 300, Sioux Falls, SD 57105-1045 | 2006-05-12 |
| 1437123320 | Erik Douglas Peterson | Orthopaedic Surgery | 810 E 232rd St, Sioux Falls, SD 57105 | 2006-02-15 |
| 1275530644 | Timothy L Walker | Orthopaedic Surgery | 1210 W 18th St Ste G01, Sioux Falls, SD 57104-4651 | 2005-06-30 |
| 1861022543 | Manus, LLC | Orthopaedic Surgery | 810 E 23rd St, Sioux Falls, SD 57105-2135 | 2020-01-22 |
| 1669735676 | Harvey Anthony Oliver IIi | Orthopaedic Surgery | 1210 W 18th St Ste G01, Sioux Falls, SD 57104-4651 | 2012-06-25 |
| 1366702326 | Jonathon Ross Geisinger | Orthopaedic Surgery | 810 E 23rd St, Sioux Falls, SD 57105 | 2012-05-24 |
| Find all providers in SIOUX FALLS | ||||
| City | SIOUX FALLS |
| Zip Code | 57104 |
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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.