SANFORD CLINIC (NPI# 1518973221) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518973221 |
| Entity Type | Organization |
| Organization Name | SANFORD CLINIC |
| Other Organization Name | SANFORD CLINIC GASTROENTEROLOGY |
| Practice Address |
1205 S Grange Ave Ste 510 Sioux Falls SD 57105-0410 |
| Mailing Address |
Po Box 5074 Sioux Falls SD 57117-5074 |
| Practice Telephone | 6053288500 |
| Practice Fax Number | 6053288501 |
| Mailing Telephone | 6053286585 |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2020-07-01 |
| 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 | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | 281988100 | 05 | |
| IA | 0537886 | 05 |
| Other Name | Type Code |
|---|---|
| Sanford Clinic Gastroenterology | 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 |
| 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 |
1205 S GRANGE AVE STE 510 |
| City | SIOUX FALLS |
| State | SD |
| Zip Code | 57105-0410 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023585833 | Lyndsey Sue Horne | Nurse Practitioner | 1205 S Grange Ave Ste 510, Sioux Falls, SD 57105-0410 | 2018-10-30 |
| 1962978726 | Laura A Bakke | Physician Assistant | 1205 S Grange Ave Ste 510, Sioux Falls, SD 57105-0410 | 2018-10-19 |
| 1245713361 | Ashley Frost | Family Medicine | 1205 S Grange Ave Ste 510, Sioux Falls, SD 57105-0410 | 2018-09-13 |
| 1902266273 | Cornelius F Boerkoel IIi | Medical Genetics | 1205 S Grange Ave Ste 510, Sioux Falls, SD 57105-0410 | 2016-03-01 |
| 1508251059 | Paresh M. Sojitra | Internal Medicine | 1205 S Grange Ave Ste 510, Sioux Falls, SD 57105-0410 | 2015-04-01 |
| 1437564820 | Antonios Wehbeh | Internal Medicine | 1205 S Grange Ave Ste 510, Sioux Falls, SD 57105-0410 | 2014-06-25 |
| 1205254547 | Parkpoom Phatharacharukul | Internal Medicine | 1205 S Grange Ave Ste 510, Sioux Falls, SD 57105-0410 | 2014-04-03 |
| 1316242365 | Andrea Joy Eben | Social Worker | 1205 S Grange Ave Ste 510, Sioux Falls, SD 57105-0410 | 2011-01-24 |
| 1568654648 | Mark Gene Lounsbery | Internal Medicine | 1205 S Grange Ave Ste 510, Sioux Falls, SD 57105-0410 | 2007-08-13 |
| 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 | 207RG0100X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Gastroenterology |
| An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386965580 | Kunut Kijsirichareanchai | Internal Medicine | 1205 S. Grange Avenue, Mb2, Suite 104, Sanford Gastroenterology Clinic, Sioux Falls, SD 57105 | 2010-06-22 |
| 1871792408 | R. D. Meyer, M.d. | Internal Medicine | 1200 S Euclid Ave Ste 210, Sioux Falls, SD 57105-0433 | 2007-07-13 |
| 1235183807 | Chandar Singaram | Internal Medicine | 1905 W 57th St Ste 1, Sioux Falls, SD 57108-2893 | 2006-05-19 |
| 1194799882 | Avera Mckennan | Internal Medicine | 6100 S Louise Ave Ste 3100, Sioux Falls, SD 57108-6021 | 2006-02-17 |
| 1063486975 | John D Barker Jr. | Internal Medicine | 1001 E. 21st St., Ste. 501, Sioux Falls, SD 57105 | 2006-02-15 |
| 1134191869 | Kozhikode Veetil Narayanan Menon | Internal Medicine | 1001 E 21st St, Suite 303, Sioux Falls, SD 57105-1033 | 2006-02-06 |
| 1295730356 | Tim M Ridgway | Internal Medicine | 1500 W 22nd St, Ste 101, Sioux Falls, SD 57105-1503 | 2005-06-16 |
| 1619972783 | Christopher Michael Hurley | Internal Medicine | 1417 S Cliff Ave, Suite 300, Sioux Falls, SD 57105-1022 | 2005-06-16 |
| 1205831377 | Jorge A Gilbert | Internal Medicine | 1205 S Grange Ave Ste 104, Sioux Falls, SD 57105-0414 | 2005-06-16 |
| 1437564820 | Antonios Wehbeh | Internal Medicine | 1205 S Grange Ave Ste 510, Sioux Falls, SD 57105-0410 | 2014-06-25 |
| 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.