SANFORD CLINIC NORTH (NPI# 1548532468) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548532468 |
| Entity Type | Organization |
| Organization Name | SANFORD CLINIC NORTH |
| Other Organization Name | SANFORD HEALTH BROADWAY CLINIC |
| Practice Address |
1527 Broadway St Alexandria MN 56308-2537 |
| Practice Telephone | 3207620399 |
| Practice Fax Number | 3207626847 |
| Mailing Telephone | 3207620399 |
| Mailing Fax Number | 3207626847 |
| Enumeration Date | 2012-02-08 |
| Last Update Date | 2019-11-21 |
| Authorized Official Name | MARTHA K LECLERC (VICE PRESIDENT) |
| Authorized Official Telephone | 7012346248 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| N | 261Q00000X | Clinic/Center | Ambulatory Health Care Facilities | ||
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | FEDERAL WORKERS COMP | 379186602 | 01 |
| MN | RR MEDICARE | DS4138 | 01 |
| Other Name | Type Code |
|---|---|
| Sanford Health Broadway Clinic | 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 |
1527 BROADWAY ST |
| City | ALEXANDRIA |
| State | MN |
| Zip Code | 56308-2537 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649279753 | Thomas Joseph Holsinger | Podiatrist | 1527 Broadway St, Alexandria, MN 56308-2537 | 2005-07-20 |
| 1366892689 | Laurie A Chittum | Nurse Practitioner | 1527 Broadway St, Alexandria, MN 56308-2537 | 2016-06-17 |
| 1396108437 | Britney A Mach | Physician Assistant | 1527 Broadway St, Alexandria, MN 56308-2537 | 2016-04-04 |
| 1124487038 | Jacob Timothy Mach | Physician Assistant | 1527 Broadway St, Alexandria, MN 56308-2537 | 2016-02-19 |
| 1245602119 | Megan Larsen | Nurse Practitioner | 1527 Broadway St, Alexandria, MN 56308-2537 | 2015-10-30 |
| 1639548795 | Casey B Hovendick | Nurse Practitioner | 1527 Broadway St, Alexandria, MN 56308-2537 | 2015-09-18 |
| 1790191435 | Samuel Hintz | Psychologist | 1527 Broadway St, Alexandria, MN 56308-2537 | 2014-07-02 |
| 1215342068 | Kaylee Miller | Podiatrist | 1527 Broadway St, Alexandria, MN 56308-2537 | 2014-06-30 |
| 1043551773 | Sarah Lyn Feierabend | Registered Nurse | 1527 Broadway St, Alexandria, MN 56308-2537 | 2013-03-05 |
| 1104108166 | Anne G Gilbertson | Advanced Practice Midwife | 1527 Broadway St, Alexandria, MN 56308-2537 | 2011-09-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871104836 | Center for Pain Management Ambulatory Surgery, Ltd | Pain Medicine | 804 23rd Street South, Sartell, MN 56308 | 2020-08-13 |
| 1548815590 | Ritajo Ellenberger | Licensed Practical Nurse | 220 Oak Street North, Alexandria, MN 56308 | 2019-08-06 |
| 1346808714 | Vance Thompson Vision Surgery Center Alexandria, Prof LLC | Clinic/Center | 2600 Jefferson St, Alexandria, MN 56308 | 2019-05-31 |
| 1811452048 | Little Falls Eye Care Center Pa | Optometrist | 2306 S. Broadway Str. Suite 12, Alexandria, MN 56308 | 2019-02-01 |
| 1184167199 | Jennifer Lynn Craig | Technician | 2307 East Golf Course Rd, Alexandria, MN 56308 | 2016-11-22 |
| 1548712219 | Shelby Elisha Johnsrud | Chiropractor | 303 West 22nd Ave, Ste 100, Alexandria, MN 56308 | 2016-10-28 |
| 1811347867 | Dustin Matthew Ditch | Dentist | 510 22nd Ave E Ste 702, Alexandria, MN 56308 | 2016-06-20 |
| 1639538051 | West Central Chiropractic & Wellness, LLC | Chiropractor | 123 3rd Ave. E, Suite 100, Alexandria, MN 56308 | 2016-02-12 |
| 1659736221 | Amanda Jean Dahlseng | Registered Nurse | 809 Elm Street, Suite 1200, Alexandria, MN 56308 | 2015-12-23 |
| 1518358886 | Benjamin G Wenzel | Marriage & Family Therapist | 512 30th Ave S, Ste 100, Alexandria, MN 56308 | 2015-02-09 |
| Find all providers in zip 56308 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609489483 | Thompson Md LLC | Family Medicine | 7906 Andrus Rd Ste 8, Alexandria, VA 22306-3169 | 2020-08-31 |
| 1770147597 | Winn Community Health Center, Inc. | Family Medicine | 601 Cloverleaf Blvd, Alexandria, LA 71303-3808 | 2019-04-26 |
| 1477094860 | Kwabena Bonsu Owusu-boateng | Family Medicine | 8109 Tis Well Drive, Suite 511, Alexandria, VA 22306 | 2017-03-17 |
| 1821475823 | Shrey Carpenter | Family Medicine | 3000 Potomac Ave, Alexandria, VA 22305-3084 | 2015-04-29 |
| 1104161801 | Loudoun Medical Group PC | Family Medicine | 901 N Pitt Street, Suite 150, Alexandria, VA 22314-1564 | 2012-12-06 |
| 1730423856 | Patient First Richmond Medical Group Pllc | Family Medicine | 6311 Richmond Highway, Alexandria, VA 22306 | 2012-11-15 |
| 1235484189 | Michelle R Beurlot | Family Medicine | 1587 N Bolton Ave Ste 1100, Alexandria, LA 71303-4255 | 2012-07-17 |
| 1225324775 | David Nicholas Aymond | Family Medicine | 821 Elliott Street, Alexandria, LA 71301 | 2011-06-23 |
| 1902197544 | Sofia H Qureshi | Family Medicine | 300 Commercial Circle, Alexandria, KY 41001-2107 | 2011-05-01 |
| 1215258165 | Anca I Sisu | Family Medicine | 20 S Quaker Ln Ste 220, Alexandria, VA 22314-4500 | 2010-06-15 |
| Find all providers in ALEXANDRIA | ||||
| City | ALEXANDRIA |
| Zip Code | 56308 |
Please comment or provide details below to improve the information on SANFORD CLINIC NORTH.
| 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.