SANFORD CLINIC (NPI# 1346529211) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346529211 |
| Entity Type | Organization |
| Organization Name | SANFORD CLINIC |
| Other Organization Name | SANFORD CLINIC RADIATION ONCOLOGY |
| Practice Address |
1309 W 17th St Sioux Falls SD 57104-4663 |
| Mailing Address |
Po Box 5074 Sioux Falls SD 57117-5074 |
| Practice Telephone | 6053286001 |
| Practice Fax Number | 6053286045 |
| Mailing Telephone | 6053286585 |
| Mailing Fax Number | 6053127611 |
| Enumeration Date | 2011-08-10 |
| Last Update Date | 2020-06-30 |
| 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 |
|---|---|---|---|---|---|
| Y | 2085R0001X |
Radiology Specialization: Radiation Oncology |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Sanford Clinic Radiation Oncology | 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 |
1309 W 17TH ST |
| City | SIOUX FALLS |
| State | SD |
| Zip Code | 57104-4663 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437155140 | Miroslaw A Mazurczak | Internal Medicine | 1309 W 17th St, Ste 101, Sioux Falls, SD 57104-8805 | 2005-06-27 |
| 1164064226 | Kimberly Caye Niemann | Nurse Practitioner | 1309 W 17th St, Sioux Falls, SD 57104-4663 | 2019-10-10 |
| 1982160206 | Marin Melissa Schaefer | Nurse Practitioner | 1309 W 17th St, Sioux Falls, SD 57104-4663 | 2019-02-11 |
| 1992299614 | Kelly Anne Tolley | Nurse Practitioner | 1309 W 17th St, Sioux Falls, SD 57104-4663 | 2018-06-16 |
| 1881190312 | Emily Joy Hutchinson | Counselor | 1309 W 17th St, Sioux Falls, SD 57104-4663 | 2018-04-03 |
| 1003366055 | Sanford Home Medical Equipment | Durable Medical Equipment & Medical Supplies | 1309 W 17th St, Ste G403c, Sioux Falls, SD 57104-4663 | 2016-10-13 |
| 1497127005 | Kimberly Rae Hamer | Nurse Practitioner | 1309 W 17th St, Ste 101, Sioux Falls, SD 57104-4663 | 2015-10-22 |
| 1023426350 | Heather Casper-mclay | Nurse Practitioner | 1309 W 17th St, Suite 101, Sioux Falls, SD 57104-4663 | 2014-07-30 |
| 1497163026 | Sanford Clinic | Family Medicine | 1309 W 17th St, Ste G01, Sioux Falls, SD 57104-4663 | 2014-07-28 |
| 1285906156 | Larissa L Risty | Genetic Counselor, MS | 1309 W 17th St, Sioux Falls, SD 57104-4663 | 2012-02-07 |
| 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 | 2085R0001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Radiation Oncology |
| A radiologist who deals with the therapeutic applications of radiant energy and its modifiers and the study and management of disease, especially malignant tumors. |
| 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 Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760625768 | Kyle Owen Arneson | Radiology | 1000 E 23rd St Ste 100, Sioux Falls, SD 57105-2114 | 2009-04-07 |
| 1477847861 | Avera Mckennan | Radiology | 1000 E. 23rd St., Ste. 100, Sioux Falls, SD 57105-2113 | 2011-06-03 |
| 1710270061 | Joel L Grow | Radiology | 1000 E 23rd St Ste 100, Sioux Falls, SD 57105-2114 | 2011-05-19 |
| 1265691133 | Ryan K Nowak | Radiology | 1309 W 17th St, Sioux Falls, SD 57104-4663 | 2008-06-05 |
| 1487840237 | Sanford Clinic | Radiology | 5019 S Western Ave, Sioux Falls, SD 57108 | 2007-09-14 |
| 1326187477 | Medical Xray Center PC | Radiology | 1417 S Minnesota Ave, Sioux Falls, SD 57105-1715 | 2007-02-05 |
| 1134206949 | Barbara Anne Schlager | Radiology | 1000 E 23rd St, Ste 100, Sioux Falls, SD 57105-2114 | 2006-11-01 |
| 1174537799 | Sanford Clinic | Radiology | 1309 W 17th St, Sioux Falls, SD 57104-4663 | 2006-07-28 |
| 1396702338 | Steven Mcgraw | Radiology | 1309 W 17th St, Sioux Falls, SD 57104-4663 | 2006-04-26 |
| 1891757290 | Kathleen Lynne Schneekloth | Radiology | 1000 E 23rd St, Ste 100, Sioux Falls, SD 57105-2114 | 2006-04-03 |
| 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.