SANFORD CLINIC NORTH (NPI# 1972660991) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972660991 |
| Entity Type | Organization |
| Organization Name | SANFORD CLINIC NORTH |
| Other Organization Name | SANFORD HEALTH 1611 NORTH EYE CENTER & OPTICAL |
| Practice Address |
1233 34th St Nw Bemidji MN 56601-5112 |
| Mailing Address |
1611 Anne St Nw Bemidji MN 56601-5114 |
| Practice Telephone | 2183335000 |
| Practice Fax Number | 7012342045 |
| Mailing Telephone | 2183332020 |
| Mailing Fax Number | 7012342045 |
| Enumeration Date | 2007-01-02 |
| 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 | 332H00000X | Eyewear Supplier (Equipment, not the service) | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NDBC | 801770 | 01 | |
| MNBC | 4C334BE | 01 |
| Other Name | Type Code |
|---|---|
| Sanford Health 1611 North Eye Center & Optical | 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 |
| 1255348280 | Sanford Clinic North | Clinic/Center | 21 Wiley Avenue South, Lidgerwood, ND 58053-4001 | 2006-08-02 |
| 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 |
1233 34TH ST NW |
| City | BEMIDJI |
| State | MN |
| Zip Code | 56601-5112 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093775900 | David Alan Vanengelenhoven | Emergency Medicine | 1233 34th St Nw, Meritcare Clinic, Bemidji, MN 56601 | 2006-03-24 |
| 1467063297 | Melissa Cook | Social Worker | 1233 34th St Nw, Bemidji, MN 56601-5112 | 2020-08-14 |
| 1669961561 | Sanford Clinic North | Durable Medical Equipment & Medical Supplies | 1233 34th St Nw, Bemidji, MN 56601-5112 | 2018-05-07 |
| 1164956645 | Sanford Clinic North | Pharmacist | 1233 34th St Nw, Sanford Clinic Pharmacy, Bemidji, MN 56601-5112 | 2017-04-12 |
| 1982055661 | Emmanuel Ortiz Erestain | Internal Medicine | 1233 34th St Nw, Bemidji, MN 56601-5112 | 2016-06-24 |
| 1821407453 | Jennifer Leonhard | Genetic Counselor, MS | 1233 34th St Nw, Bemidji, MN 56601-5112 | 2014-08-07 |
| 1235553140 | Gretchen Lee Bonik | Pharmacist | 1233 34th St Nw, Bemidji, MN 56601-5112 | 2014-02-12 |
| 1023350949 | Terry Joseph Luma | Family Medicine | 1233 34th St Nw, Bemidji, MN 56601-5112 | 2013-03-18 |
| 1841544160 | Brittany Dawn Smith | Dietitian, Registered | 1233 34th St Nw, Bemidji, MN 56601-5112 | 2012-11-08 |
| 1043565757 | Jayasri Alapati | Psychiatry & Neurology | 1233 34th St Nw, Bemidji, MN 56601-5112 | 2012-07-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336772425 | Northern Minnesota Addiction Wellness Center | Substance Abuse Rehabilitation Facility | 4851 Stacy Ann Dr Nw, Bemidji, MN 56601 | 2020-02-17 |
| 1366093841 | Vickie Lynn Matthews | Technician | 1018 Miles Ave Se, Bemidji, MN 56601 | 2019-09-25 |
| 1518443530 | Lindsey Marie Whiting | Registered Nurse | 1300 Anne St, Bemidji, MN 56601 | 2018-07-12 |
| 1801257662 | Meghan Zigrida Paquette | Registered Nurse | 6055 161st Street Nw, Cass Lake, MN 56601 | 2016-03-08 |
| 1144686106 | Northwest Indian Oic | Home Health | 1819 Bemidji Ave N Ste 1, Bemidji, MN 56601 | 2016-01-06 |
| 1831560424 | Laura Hansen, Msw, Licsw Counseling Services, Inc. | Social Worker | 403 4th Street Ne, Suite 110, Bemidji, MN 56601 | 2015-10-08 |
| 1679949028 | Grand St. Paul Cvs LLC | Durable Medical Equipment & Medical Supplies | 2312 Bemidji Ave North, Bemidji, MN 56601 | 2015-08-19 |
| 1255717617 | Mary S. Salter, Md Psc | Internal Medicine | 514 Beltrami Ave Nw Suite 102, Bemidji, MN 56601 | 2015-08-07 |
| 1225420615 | Cristin Evans | Counselor | 403 4th Street, Suite 300, Bemidji, MN 56601 | 2015-02-23 |
| 1619367919 | Angela Krom Fournier | Psychologist | 16150 Golden Eagle Court Nw, Eagle Vista Equine Center Inc., Bemidji, MN 56601 | 2015-01-26 |
| Find all providers in zip 56601 | ||||
| Taxonomy Code | 332H00000X |
| Grouping | Suppliers |
| Classification | Eyewear Supplier (Equipment, not the service) |
| An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548540842 | Sanford Medical Center Fargo | Eyewear Supplier (Equipment, not the service) | 1611 Anne St Nw, Bemidji, MN 56601-5114 | 2011-08-18 |
| 1144367590 | Womack Opticians | Eyewear Supplier (Equipment, not the service) | 1405 Anne St Nw, Bemidji, MN 56601-5113 | 2007-02-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801493903 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 11995 Business Park Blvd N, Champlin, MN 55316 | 2020-10-02 |
| 1659920460 | Jand. Inc. | Eyewear Supplier (Equipment, not the service) | 3408 Galleria, Edina, MN 55435 | 2019-09-05 |
| 1891351268 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 1101 E College Dr, Marshall, MN 56258-2366 | 2019-05-11 |
| 1730745100 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 1459 W Service Dr, Winona, MN 55987-2512 | 2019-05-11 |
| 1649836016 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 1023 E Blue Earth Ave, Fairmont, MN 56031-4076 | 2019-05-11 |
| 1124684592 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 1004 18th Ave Nw Ste D, Austin, MN 55912-1993 | 2019-05-11 |
| 1053977421 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 1620 Broadway Ave S Ste 4, Rochester, MN 55904-7927 | 2019-05-11 |
| 1942866371 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 4051 W Division St Ste A, Saint Cloud, MN 56301-3741 | 2019-05-10 |
| 1831651165 | Don Sealock, O.d., P.a. | Eyewear Supplier (Equipment, not the service) | 3366 Oakdale Ave N Ste 140, Robbinsdale, MN 55422-2961 | 2019-04-04 |
| 1538624341 | Don Sealock, O.d., P.a. | Eyewear Supplier (Equipment, not the service) | 9825 Hospital Dr # 106, Maple Grove, MN 55369-4479 | 2019-02-06 |
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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.