SANFORD MEDICAL CENTER FARGO (NPI# 1366092801) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366092801 |
| Entity Type | Organization |
| Organization Name | SANFORD MEDICAL CENTER FARGO |
| Other Organization Name | SANFORD FARGO HOSPICE HOUSE |
| Practice Address |
820 4th St N Fargo ND 58102-4539 |
| Mailing Address |
Po Box 2168 Fargo ND 58107-2168 |
| Practice Telephone | 7012347550 |
| Practice Fax Number | 7012347559 |
| Mailing Telephone | 6053286585 |
| Enumeration Date | 2019-09-17 |
| Last Update Date | 2020-06-30 |
| Authorized Official Name | TONY LEE MORRISON (VICE PRESIDENT, REVENUE CYCLE) |
| Authorized Official Telephone | 6053288380 |
| Is Organization Subpart | Y |
| Parent Organization Name | SANFORD |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251G00000X | Hospice Care, Community Based | Agencies |
| Other Name | Type Code |
|---|---|
| Sanford Fargo Hospice | Doing Business As Name - Organization |
| Sanford Fargo Hospice House | Doing Business As Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 801 Broadway N, Fargo, ND 581023641 | 7012345264 | 7012347326 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245519081 | Sanford Medical Center Fargo | General Acute Care Hospital | 2990 Seter Parkway, Fargo, ND 58104-8750 | 2011-08-10 |
| 1558458844 | Sanford Medical Center Fargo | Pharmacy | 1720 S University Drive, Fargo, ND 58103-4940 | 2006-10-06 |
| 1578508198 | Sanford Medical Center Fargo | Clinic/Center | 1234 Washington Ave Ste B, Detroit Lakes, MN 56501-3906 | 2006-06-18 |
| 1225635634 | Sanford Medical Center Fargo | Pharmacy | 1720 University Dr S, Fargo, ND 58103-4940 | 2020-10-08 |
| 1174120281 | Sanford Medical Center Fargo | Pharmacy | 5225 23rd Ave S, Fargo, ND 58104-7927 | 2020-10-02 |
| 1013559905 | Sanford Medical Center Fargo | Hospice Care, Community Based | 801 Broadway N, Fargo, ND 58102-3641 | 2019-10-11 |
| 1861927709 | Sanford Medical Center Fargo | Pharmacy | 5225 23rd Ave S, Fargo, ND 58104 | 2017-04-28 |
| 1801151394 | Sanford Medical Center Fargo | Clinic/Center | 2400 32nd Ave S, Fargo, ND 58103-5800 | 2012-07-10 |
| 1366717118 | Sanford Medical Center Fargo | Clinic/Center | 1245 Washington Ave, Detroit Lakes, MN 56501-3905 | 2012-03-13 |
| 1861772162 | Sanford Medical Center Fargo | Internal Medicine | 1412 Main Street, Hawley, MN 56549-0746 | 2011-08-18 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | SANFORD MEDICAL CENTER FARGO | 720 N 4th St, Fargo, ND 58122-4520 |
| Street Address |
820 4TH ST N |
| City | FARGO |
| State | ND |
| Zip Code | 58102-4539 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922025907 | Anu G Gaba | Internal Medicine | 820 4th St N, Fargo, ND 58122-0001 | 2006-07-16 |
| 1023629631 | Pauline Aamodt | Genetic Counselor, MS | 820 4th St N, Fargo, ND 58102-4539 | 2020-08-17 |
| 1710507561 | Brittany Nicole Twiss | Dietitian, Registered | 820 4th St N, Fargo, ND 58102-4539 | 2020-04-22 |
| 1154807741 | Morgan Rinke | Nurse Practitioner | 820 4th St N, Fargo, ND 58102-4539 | 2018-07-17 |
| 1497269583 | Ethan Joseph Brenna | Genetic Counselor, MS | 820 4th St N, Fargo, ND 58102-4539 | 2017-11-28 |
| 1265885867 | Carrie Pfaff | Nurse Practitioner | 820 4th St N, Fargo, ND 58102-4539 | 2016-07-19 |
| 1316315385 | Sharri M Lacher | Clinical Nurse Specialist | 820 4th St N, Fargo, ND 58102-4539 | 2015-09-09 |
| 1487022885 | John Roll | Clinical Nurse Specialist | 820 4th St N, Fargo, ND 58102-4539 | 2015-09-02 |
| 1699181495 | Kirk David Wyatt | Pediatrics | 820 4th St N, Fargo, ND 58102-4539 | 2014-07-01 |
| 1205247913 | Sommer Rae Wild Nurkic | Radiology | 820 4th St N, Fargo, ND 58102-4539 | 2014-05-15 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780285924 | Shelley Dene Townsend-hansen | Dentist | 1017 Broadway N, Fargo, ND 58102 | 2020-11-04 |
| 1275190779 | Anthony Joseph Duncan | Student in an Organized Health Care Education/Training Program | 1919 Elm Streent North, Fargo, ND 58102 | 2019-05-21 |
| 1003472317 | Sadie Marie Nelson | Nurse Practitioner | Sanford Broadway Clinic, 801 North Broadway, Fargo, ND 58102 | 2019-05-13 |
| 1124523576 | Christopher Peroutka | Specialist/Technologist | 1300 17th Ave N, Fargo, ND 58102 | 2018-03-28 |
| 1205331873 | Nathan Koens | Specialist/Technologist | 1300 17th Avenue North, Fargo, ND 58102 | 2018-03-27 |
| 1376063370 | Abby Nicole Fredrickson | Student in an Organized Health Care Education/Training Program | 1919 Elm Street North, Fargo, ND 58102 | 2017-06-21 |
| 1780118331 | Stephanie Melquist | Internal Medicine | Internal Medicine Resident Clinic, 801 N Broadway, Fargo, ND 58102 | 2017-04-19 |
| 1104215623 | Justin Lervik | Social Worker | 211 Elm St. N, 122, Fargo, ND 58102 | 2015-01-21 |
| 1770919441 | Courtney Ann Simanski | Speech-Language Pathologist | 415 4th St. N., Fargo, ND 58102 | 2013-09-25 |
| 1821431206 | Lanell Staroba | Pharmacist | 706 D 38th St, Fargo, ND 58102 | 2013-04-16 |
| Find all providers in zip 58102 | ||||
| Taxonomy Code | 251G00000X |
| Grouping | Agencies |
| Classification | Hospice Care, Community Based |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316501422 | Chi Health Connect At Home - Fargo | Hospice Care, Community Based | 5300 12th St S, Fargo, ND 58104-4034 | 2019-04-24 |
| 1588866685 | Tami's Angels, Inc. | Hospice Care, Community Based | 624 Main Ave, Suite 10, Fargo, ND 58103-1966 | 2007-06-01 |
| 1013559905 | Sanford Medical Center Fargo | Hospice Care, Community Based | 801 Broadway N, Fargo, ND 58102-3641 | 2019-10-11 |
| 1437634706 | Caringedge Hospice of Fargo | Hospice Care, Community Based | 4420 37th Ave S, Fargo, ND 58104-3400 | 2018-10-02 |
| 1598200529 | Bek Care, LLC | Hospice Care, Community Based | 3361 45th St S Ste 100, Fargo, ND 58104 | 2016-12-29 |
| 1538253646 | Hospice of The Red River Valley | Hospice Care, Community Based | 1701 38th St S, Fargo, ND 58103-4499 | 2006-10-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841647542 | Chi Health Connect At Home - Fargo | Hospice Care, Community Based | 1212 E. Maine Avenue, Bismarck, ND 58501-4518 | 2016-05-23 |
| 1578878047 | Chi Health Connect At Home-fargo | Hospice Care, Community Based | 986 2nd Avenue West, Dickinson, ND 58601-3916 | 2010-08-09 |
| 1225009038 | Mercy Hospital of Devils Lake | Hospice Care, Community Based | 1031 7th St Ne, Devils Lake, ND 58301-2798 | 2006-01-30 |
| 1740799501 | Caringedge Hospice of Minot LLC | Hospice Care, Community Based | 800 16th Ave Se, Minot, ND 58701-6781 | 2017-09-25 |
| 1093224867 | Caringedge Hospice of Bismarck LLC | Hospice Care, Community Based | 3124 Colorado Ln, Bismarck, ND 58503-5447 | 2017-09-25 |
| 1386178994 | Edgewood Management Group | Hospice Care, Community Based | 322 Demers Ave, Suite 500, Grand Forks, ND 58201-4754 | 2017-04-20 |
| 1639484140 | Chi Health Connect At Home-fargo | Hospice Care, Community Based | 1301 15th Ave W, Williston, ND 58801-3821 | 2010-08-10 |
| 1396050860 | Chi Health Connect At Home - Fargo | Hospice Care, Community Based | 367 2nd St Nw, Valley City, ND 58072-2971 | 2010-08-09 |
| 1730306812 | Hazen Memorial Hospital Association | Hospice Care, Community Based | 510 8th Ave Ne, Hazen, ND 58545-4637 | 2007-04-19 |
| 1609938661 | St. Alexius Medical Center | Hospice Care, Community Based | 1212 E Main Ave, Bismarck, ND 58501 | 2006-12-15 |
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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.