SANFORD MEDICAL CENTER FARGO (NPI# 1801151394) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801151394 |
| Entity Type | Organization |
| Organization Name | SANFORD MEDICAL CENTER FARGO |
| Other Organization Name | SANFORD MOBILE MAMMOGRAPHY |
| Practice Address |
2400 32nd Ave S Fargo ND 58103-5800 |
| Practice Telephone | 7012347100 |
| Mailing Telephone | 7012347100 |
| Enumeration Date | 2012-07-10 |
| Last Update Date | 2019-09-09 |
| 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 |
|---|---|---|---|---|---|
| Y | 261QR0207X |
Clinic/Center Specialization: Radiology, Mobile Mammography |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Sanford Mobile Mammography | Doing Business As Name - Organization |
| 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 |
| 1366092801 | Sanford Medical Center Fargo | Hospice Care, Community Based | 820 4th St N, Fargo, ND 58102-4539 | 2019-09-17 |
| 1861927709 | Sanford Medical Center Fargo | Pharmacy | 5225 23rd Ave S, Fargo, ND 58104 | 2017-04-28 |
| 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 |
2400 32ND AVE S |
| City | FARGO |
| State | ND |
| Zip Code | 58103-5800 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982693875 | Chris L Cleveland | Pediatrics | 2400 32nd Ave S, Fargo, ND 58103-5800 | 2005-10-14 |
| 1306456470 | Darcy Thompson | Registered Nurse | 2400 32nd Ave S, Fargo, ND 58103-5800 | 2020-08-04 |
| 1457988636 | Lisa Aipperspach | Dietitian, Registered | 2400 32nd Ave S, Fargo, ND 58103-5800 | 2020-03-26 |
| 1588298525 | Adriane Maag Carney | Acupuncturist | 2400 32nd Ave S, Fargo, ND 58103-5800 | 2020-02-28 |
| 1255961090 | Bailey June Hanson | Physician Assistant | 2400 32nd Ave S, Fargo, ND 58103-5800 | 2020-01-21 |
| 1013564624 | Erin Marie Wilmes | Nurse Practitioner | 2400 32nd Ave S, Fargo, ND 58103-5800 | 2019-08-20 |
| 1346896016 | Ashley Jobe | Physical Therapist | 2400 32nd Ave S, Fargo, ND 58103-5800 | 2019-08-17 |
| 1194371377 | Casey Murphy | Physical Therapist | 2400 32nd Ave S, Fargo, ND 58103-5800 | 2019-08-14 |
| 1316507221 | Evan Lee Zacharias I | Physical Therapist | 2400 32nd Ave S, Fargo, ND 58103-5800 | 2019-06-13 |
| 1801455449 | Danielle Swanson | Physician Assistant | 2400 32nd Ave S, Fargo, ND 58103-5800 | 2019-06-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659924843 | Amanda Hericks | Dentist | 1338 Gateway Drive S, Fargo, ND 58103 | 2019-07-17 |
| 1285298240 | Ann Louise Breen | Optometrist | Sanford Southpointe Eye Center & Optical, 2400 32nd Ave. S., Fargo, ND 58103 | 2019-04-25 |
| 1245706597 | Lisa Elaine Livingston | Counselor | 1337 14 and Half St. S., Fargo, ND 58103 | 2018-10-15 |
| 1528569662 | Misty Lynn Hagen | Counselor | 901 28th St. South, Suite B, Fargo, ND 58103 | 2018-02-23 |
| 1083133011 | Faith Homecare Professionals LLC | Home Health | 304 25th St S, Suite B, Fargo, ND 58103 | 2017-09-11 |
| 1982138749 | Matthew Troyer | Pharmacist | 2425 13th Ave, Fargo, ND 58103 | 2017-04-18 |
| 1801338504 | Amy Nguyen Christianson | Chiropractor | 1650 45th St S Ste 113, Fargo, ND 58103 | 2016-11-11 |
| 1245772359 | Andrea Marie Hanson | Nurse Practitioner | 2400 32nd Ave South, Fargo, ND 58103 | 2016-11-07 |
| 1831647940 | Abigail Carmen Burkett Vetter | Nurse Practitioner | 2928 University Dr S Suite 101, Fargo, ND 58103 | 2016-09-18 |
| 1013361302 | Nancy Knowlton | Speech-Language Pathologist | 3001 11th Ave S, Beyond Boundaries Speech-language, Fargo, ND 58103 | 2016-04-22 |
| Find all providers in zip 58103 | ||||
| Taxonomy Code | 261QR0207X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Radiology, Mobile Mammography |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548311145 | Dms Imaging Inc | Clinic/Center | 2101 University Dr N, Fargo, ND 58102-1816 | 2007-01-12 |
| 1326125352 | Dms Imaging Inc | Clinic/Center | 2101 University Dr N, Fargo, ND 58102-1816 | 2006-11-01 |
| 1972553758 | Dms Imaging Inc | Clinic/Center | 2101 University Dr N, Fargo, ND 58102-1816 | 2006-05-11 |
| 1871543603 | Dms Imaging Inc | Clinic/Center | 2101 University Dr N, Fargo, ND 58102-1816 | 2006-05-11 |
| 1306896139 | Dms Imaging Inc | Clinic/Center | 2101 University Dr N, Fargo, ND 58102-1816 | 2006-05-11 |
| 1427008267 | Dms Imaging Inc | Clinic/Center | 2101 University Dr N, Fargo, ND 58102-1816 | 2006-05-11 |
| 1336199173 | Dms Imaging Inc | Clinic/Center | 2101 University Dr N, Fargo, ND 58102-1816 | 2006-05-11 |
| 1477503209 | Dms Imaging Inc | Clinic/Center | 2101 University Dr N, Fargo, ND 58102-1816 | 2006-05-11 |
Please comment or provide details below to improve the information on SANFORD MEDICAL CENTER FARGO.
| 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.