SANFORD CLINIC (NPI# 1922030212) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922030212 |
| Entity Type | Organization |
| Organization Name | SANFORD CLINIC |
| Other Organization Name | SANFORD CLINIC SURGICAL ASSOCIATES |
| Practice Address |
1508 W 22nd St Ste 101 Sioux Falls SD 57105-1506 |
| Practice Telephone | 6053283840 |
| Practice Fax Number | 6053283841 |
| Mailing Telephone | 6053283840 |
| Mailing Fax Number | 6053283841 |
| Enumeration Date | 2006-07-07 |
| 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 |
|---|---|---|---|---|---|
| N | 163W00000X | Registered Nurse | Nursing Service Providers | ||
| N | 207P00000X | Emergency Medicine | Allopathic & Osteopathic Physicians | ||
| N | 208C00000X | Colon & Rectal Surgery | Allopathic & Osteopathic Physicians | ||
| N | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 208600000X | Surgery | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IA | 0537886 | 05 | |
| MN | 620091500 | 05 |
| Other Name | Type Code |
|---|---|
| Sanford Clinic Surgical Associates | 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 |
1508 W 22ND ST STE 101 |
| City | SIOUX FALLS |
| State | SD |
| Zip Code | 57105-1506 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255317038 | Jason Knudtson | Surgery | 1508 W 22nd St, Ste 101, Sioux Falls, SD 57105-1508 | 2005-12-22 |
| 1295271690 | Jennifer Anne Waller | Nurse Practitioner | 1508 W 22nd St, Suite 101, Sioux Falls, SD 57105-1508 | 2017-01-10 |
| 1508280587 | Amanda Kneip | Physician Assistant | 1508 W 22nd St, Ste 101, Sioux Falls, SD 57105-1508 | 2014-02-11 |
| 1427334341 | Cassandra L Bondesen | Nurse Practitioner | 1508 W 22nd St, Ste 101, Sioux Falls, SD 57105-1508 | 2011-10-24 |
| 1245528900 | Sarah Sorrell | Nurse Practitioner | 1508 W 22nd St, Sioux Falls, SD 57105-1508 | 2011-07-15 |
| 1386979623 | Kristin Turek | Nurse Practitioner | 1508 W 22nd St, Ste 101, Sioux Falls, SD 57105-1508 | 2009-10-05 |
| 1568692671 | Matthew David Tschetter | Surgery | 1508 W 22nd St, Ste 101, Sioux Falls, SD 57105-1508 | 2009-07-23 |
| 1326095332 | Gary Timmerman | Surgery | 1508 W 22nd St, Ste 101, Sioux Falls, SD 57105-1508 | 2006-05-27 |
| 1730136656 | Donald Graham | Surgery | 1508 W 22nd St, Ste 101, Sioux Falls, SD 57105-1508 | 2006-05-27 |
| 1972577757 | Matthew J Sorrell | Surgery | 1508 W 22nd St, Suite 101, Sioux Falls, SD 57105-1508 | 2006-02-16 |
| 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 | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932477098 | Avera Mckennan | Surgery | 1000 E 23rd St Ste 360, Sioux Falls, SD 57105-2140 | 2011-12-05 |
| 1730410465 | Philip Felix Winskunas | Surgery | 6019 E. Powderhouse Circle, Sioux Falls, SD 57110-7468 | 2010-01-20 |
| 1295991370 | Comprehensive Breast Care PC | Surgery | 911 E 20th St Ste 400, Sioux Falls, SD 57105-1046 | 2008-07-29 |
| 1740490499 | Laura M Figura | Surgery | 1417 S Cliff Ave Ste 200, Sioux Falls, SD 57105-1009 | 2007-05-23 |
| 1184724742 | Gail Waldby | Surgery | 3700 S Westport Ave # 3014, Sioux Falls, SD 57106-6360 | 2006-09-24 |
| 1750332110 | Robert K Dahl | Surgery | 911 E 20th St Ste 501, Sioux Falls, SD 57105-1047 | 2006-05-12 |
| 1255317038 | Jason Knudtson | Surgery | 1508 W 22nd St, Ste 101, Sioux Falls, SD 57105-1508 | 2005-12-22 |
| 1235796533 | Upper Midwest Medical Inc | Surgery | 4201 S Minnesota Ave Ste 112, Sioux Falls, SD 57105-6706 | 2019-05-22 |
| 1407194996 | Hassan Al Turaihi | Surgery | 1508 W 22nd St Ste 101, Sioux Falls, SD 57105-1514 | 2013-01-18 |
| 1467744201 | Stephanie Y Hung | Surgery | 2501 W. 22nd Street, Att: Dr. Hung, Sioux Falls, SD 57105 | 2011-05-12 |
| Find all providers in SIOUX FALLS | ||||
| 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.