SANFORD MEDICAL CENTER (NPI# 1841471521) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841471521 |
| Entity Type | Organization |
| Organization Name | SANFORD MEDICAL CENTER |
| Other Organization Name | SANFORD USD MEDICAL CENTER |
| Practice Address |
1305 W 18th St Sioux Falls SD 57105-0401 |
| Mailing Address |
Po Box 5074 Sioux Falls SD 57117-5074 |
| Practice Telephone | 6053331000 |
| Mailing Telephone | 6053286585 |
| Mailing Fax Number | 6053286512 |
| Enumeration Date | 2007-11-21 |
| Last Update Date | 2019-11-14 |
| Authorized Official Name | MICHELLE A BRUHN (CFO) |
| Authorized Official Telephone | 6053336450 |
| Is Organization Subpart | Y |
| Parent Organization Name | SANFORD MEDICAL CENTER |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080N0001X |
Pediatrics Specialization: Neonatal-Perinatal Medicine |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SD | 0230010 | 05 | |
| MN | 875747000 | 05 |
| Other Name | Type Code |
|---|---|
| Sanford USD Medical Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881110484 | Sanford Medical Center | Clinic/Center | 1321 W 22nd St, Sioux Falls, SD 57105-1502 | 2017-08-16 |
| 1407107808 | Sanford Medical Center | General Acute Care Hospital | 1210 W 18th St, Suite Llo1, Sioux Falls, SD 57104-4647 | 2012-09-25 |
| 1093090342 | Sanford Medical Center | Nurse Practitioner | 1305 W 18th St, Sioux Falls, SD 57105-0401 | 2011-10-19 |
| 1588845267 | Sanford Medical Center | Clinic/Center | 1305 W 18th St, Sioux Falls, SD 57105-0401 | 2007-11-21 |
| 1023299708 | Sanford Medical Center | Ambulance | 1305 W 18th St, Sioux Falls, SD 57105-0401 | 2007-11-21 |
| 1932380615 | Sanford Medical Center | Ambulance | 1305 W 18th St, Sioux Falls, SD 57105-0401 | 2007-11-21 |
| 1932123452 | Sanford Medical Center | Rehabilitation Unit | 1305 W 18th St, Sioux Falls, SD 57105-0401 | 2006-07-27 |
| 1912921438 | Sanford Medical Center | Clinic/Center | 1305 W 18th St, Sioux Falls, SD 57105-0401 | 2006-07-27 |
| 1538181326 | Sanford Medical Center | Clinic/Center | 323 Sw 10th St, Madison, SD 57042 | 2006-07-24 |
| 1326060054 | Sanford Medical Center | Clinic/Center | 111 Washington St, Wagner, SD 57380 | 2006-07-24 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Iowa Business Entities | SANFORD MEDICAL CENTER | 1305 W. 18th Street, Sioux Falls, SD 57105 |
| Colorado Business Entities | Sanford Medical Center | 1305 W. 18th Street, Sioux Falls, SD 57105 |
| System for Award Management (SAM) Entities | SANFORD MEDICAL CENTER | 1305 W 18th St, Sioux Falls, SD 57105-0401 |
| Oregon Corporations, Companies and Business Names | SANFORD MEDICAL CENTER | 1305 W 18th Street, Sioux Falls, SD 57105 |
| Washington State Corporations | SANFORD MEDICAL CENTER | 1305 W 18th St, Sioux Falls, SD 57105-0401 |
| System for Award Management (SAM) Entities | SANFORD MEDICAL CENTER FARGO | 720 N 4th St, Fargo, ND 58122-4520 |
| System for Award Management (SAM) Entities | SANFORD MEDICAL CENTER MAYVILLE | 42 6th Ave Se, Mayville, ND 58257-1506 |
| System for Award Management (SAM) Entities | SANFORD MEDICAL CENTER THIEF RIVER FALLS | 120 Labree Ave S Ste A, Thief River Falls, MN 56701-2840 |
| Connecticut Business Registrations | SANFORD MEDICAL CENTER, INC. | 1305 W. 18th Street, Sioux Falls, SD 57105 |
| Street Address |
1305 W 18TH ST |
| City | SIOUX FALLS |
| State | SD |
| Zip Code | 57105-0401 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558366500 | Scott Pham | Internal Medicine | 1305 W 18th St, Sioux Falls, SD 57105-0401 | 2005-06-16 |
| 1295336279 | Lindsey Marie Palmer | Registered Nurse | 1305 W 18th St, Sioux Falls, SD 57105-0401 | 2020-11-05 |
| 1437757622 | Gregory P Studer | Nurse Practitioner | 1305 W 18th St, Sioux Falls, SD 57105-0401 | 2020-10-11 |
| 1992316772 | Kyle Garrett Wescott | Nurse Anesthetist, Certified Registered | 1305 W 18th St, Sioux Falls, SD 57105-0401 | 2020-08-13 |
| 1205445871 | Elizabeth Halverson | Nurse Anesthetist, Certified Registered | 1305 W 18th St, Sioux Falls, SD 57105-0401 | 2020-07-29 |
| 1174149710 | Kyle Mamer | Nurse Anesthetist, Certified Registered | 1305 W 18th St, Sioux Falls, SD 57105-0401 | 2020-06-19 |
| 1750906186 | Gabriel Steinborn | Anesthesiology | 1305 W 18th St, Sioux Falls, SD 57105-0401 | 2020-06-11 |
| 1972128692 | Carrie Jane Anderson | Nurse Anesthetist, Certified Registered | 1305 W 18th St, Sioux Falls, SD 57105-0401 | 2020-06-09 |
| 1437772134 | Laura Anne Taylor | Nurse Anesthetist, Certified Registered | 1305 W 18th St, Sioux Falls, SD 57105-0401 | 2020-05-28 |
| 1215550991 | Ana Beatriz Nevarez Gilbert | Student in an Organized Health Care Education/Training Program | 1305 W 18th St, Sioux Falls, SD 57105 | 2020-05-28 |
| Find all providers in the same location | ||||
| 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 | 2080N0001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Neonatal-Perinatal Medicine |
| A pediatrician who is the principal care provider for sick newborn infants. Clinical expertise is used for direct patient care and for consulting with obstetrical colleagues to plan for the care of mothers who have high-risk pregnancies. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104896083 | Jose Marius D Dosado | Pediatrics | 1325 S. Cliff Ave., Sioux Falls, SD 57105-1007 | 2006-01-24 |
| 1548737018 | Jacqueline Deborah Weidauer | Pediatrics | 1600 W 22nd St, Sioux Falls, SD 57105-1521 | 2018-11-01 |
| 1285054858 | Taylor Hansen | Pediatrics | 1325 S Cliff Ave, Sioux Falls, SD 57105-1007 | 2014-04-22 |
| 1487099289 | Kathryn Marie Anderson | Pediatrics | 1600 W 22nd St, Sioux Falls, SD 57105-1521 | 2013-05-07 |
| 1790925311 | Fernando Augusto Soares | Pediatrics | 1325 S. Cliff Ave., Sioux Falls, SD 57105-1007 | 2009-02-22 |
| 1427258318 | Maria Margarita Talavera Barber | Pediatrics | 1325 S Cliff Ave, Sioux Falls, SD 57105-1007 | 2007-07-19 |
| 1073585949 | Avera Mckennan | Pediatrics | 1325 S. Cliff Ave., Sioux Falls, SD 57105-1007 | 2006-02-06 |
| 1952371825 | Kandi Mcmenamy | Pediatrics | 1325 S. Cliff Ave., Sioux Falls, SD 57105-1007 | 2006-01-24 |
| 1780654665 | Samuel E Rogers | Pediatrics | 1325 S. Cliff Ave., Sioux Falls, SD 57105-1007 | 2006-01-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205321494 | B&b Neonatology | Pediatrics | 3213 W Main St Ste 128, Rapid City, SD 57702-2314 | 2018-06-29 |
| 1881917078 | Kimberly Sierra Balay | Pediatrics | 4140 Penrose Pl, Rapid City, SD 57702-6828 | 2010-03-02 |
| 1639229727 | Black Hills Pediatrics and Neonatology | Pediatrics | 2905 5th St, Rapid City, SD 57701-7316 | 2007-01-11 |
| 1063437085 | Stephen M Kovarik | Pediatrics | 2905 5th St, Rapid City, SD 57701-7316 | 2006-07-12 |
| 1346265394 | Steven I Benn | Pediatrics | 2905 5th St, Rapid City, SD 57701-7316 | 2006-07-12 |
| 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.