SANFORD MEDICAL CENTER FARGO (NPI# 1821154253) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821154253 |
| Entity Type | Organization |
| Organization Name | SANFORD MEDICAL CENTER FARGO |
| Other Organization Name | SANFORD DIALYSIS FARGO |
| Practice Address |
2801 University Dr S Fargo ND 58103-6029 |
| Mailing Address |
Po Box 2168 Fargo ND 58107-2168 |
| Practice Telephone | 7012348400 |
| Mailing Telephone | 7012342119 |
| Enumeration Date | 2006-12-29 |
| Last Update Date | 2020-07-07 |
| 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 | 261QE0700X |
Clinic/Center Specialization: End-Stage Renal Disease (ESRD) Treatment |
5068A | ND | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NDBC | 000026 | 01 | |
| MNBC | 1466HLU | 01 | |
| ND | 1018 | 05 | |
| MN | 160110500 | 05 |
| Other Name | Type Code |
|---|---|
| Sanford Dialysis Fargo | 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 |
| 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 |
| 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 |
2801 UNIVERSITY DR S |
| City | FARGO |
| State | ND |
| Zip Code | 58103-6029 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861419723 | Catherine M Garvey | Physician Assistant | 2801 University Dr S, Fargo, ND 58103-6029 | 2006-07-16 |
| 1558975680 | Mackenzie Yaggie | Nurse Practitioner | 2801 University Dr S, Fargo, ND 58103-6029 | 2020-09-05 |
| 1508482704 | Shaun Earl Seibold | Nurse Practitioner | 2801 University Dr S, Fargo, ND 58103-6029 | 2020-06-23 |
| 1518349372 | Aubrie Hall | Speech-Language Pathologist | 2801 University Dr S, Fargo, ND 58103-6029 | 2015-06-29 |
| 1770849911 | April Alisa Qualley | Nurse Practitioner | 2801 University Dr S, Plastic Surgery, Fargo, ND 58103-6029 | 2012-04-02 |
| 1033499330 | Sanford Medical Center Fargo | Internal Medicine | 2801 University Dr S, Fargo, ND 58103-6029 | 2011-08-18 |
| 1902186208 | Sanford Clinic North | Internal Medicine | 2801 University Dr S, Fargo, ND 58103-6029 | 2011-08-18 |
| 1104123298 | Heidi L Saarinen | Nurse Practitioner | 2801 University Dr S, Fargo, ND 58103-6029 | 2011-02-25 |
| 1477878114 | Sanford Healthcare Accessories, LLC | Durable Medical Equipment & Medical Supplies | 2801 University Dr S, Fargo, ND 58103-6029 | 2010-04-06 |
| 1053548107 | Amy Iva Stevahn | Registered Nurse | 2801 University Dr S, Fargo, ND 58103-6029 | 2009-06-16 |
| 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 | 261QE0700X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | End-Stage Renal Disease (ESRD) Treatment |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356532550 | Davita Dakota Dialysis Center LLC | Clinic/Center | 4474 23rd Ave S, Ste M, Fargo, ND 58104-8795 | 2007-08-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609035997 | Renal Treatment Centers West Inc | Clinic/Center | 413 South 7th St, Oakes, ND 58474-1920 | 2008-06-03 |
| 1396828547 | Sanford Bismarck | Clinic/Center | #10 N River Rd, Fort Yates, ND 58538 | 2006-10-23 |
| 1083625354 | Three Affiliated Tribes Kidney Dialysis Unit | Clinic/Center | 9281 Highway 23, New Town, ND 58763-9407 | 2006-08-11 |
| 1003809948 | Kidney Institute of North Dakota, LLC | Clinic/Center | 1451 - 44th Avenue South Suite 112-d, Grand Forks, ND 58201-4055 | 2005-08-25 |
| 1740822899 | Bio-medical Applications of Minnesota Inc | Clinic/Center | 1200 S Columbia Rd, Grand Forks, ND 58201-4036 | 2019-10-10 |
| 1447892591 | Bio-medical Applications of Minnesota Inc | Clinic/Center | 1031 7th St Ne, Devils Lake, ND 58301-2719 | 2019-10-10 |
| 1417143710 | Aurora Dialysis, LLC | Clinic/Center | 1451 44th Ave S, Suite 104d, Grand Forks, ND 58201-3434 | 2007-09-20 |
| 1972667673 | St. Alexius Medical Center | Clinic/Center | 900 E Broadway Ave, Bismarck, ND 58501-4520 | 2006-12-20 |
| 1376605600 | St. Alexius Medical Center | Clinic/Center | 1301 15th Ave W, Williston, ND 58801-3821 | 2006-12-14 |
| 1861553844 | St. Alexius Medical Center | Clinic/Center | 2500 Fairway St, Dickinson, ND 58601-2639 | 2006-12-13 |
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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.