SANFORD CLINIC (NPI# 1912087370) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912087370 |
| Entity Type | Organization |
| Organization Name | SANFORD CLINIC |
| Other Organization Name | SANFORD CLINIC WORTHINGTON PSYCHIATRY |
| Practice Address |
1680 Diagonal Rd Worthington MN 56187-1008 |
| Practice Telephone | 5073723800 |
| Mailing Telephone | 5073723800 |
| Mailing Fax Number | 5073723806 |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2019-11-25 |
| Authorized Official Name | STEVE W GOETSCH (CFO) |
| Authorized Official Telephone | 6053288395 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 103T00000X | Psychologist | Behavioral Health & Social Service Providers |
| Other Name | Type Code |
|---|---|
| Sanford Clinic Worthington Psychiatry | 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 |
| Oklahoma Business Registrations | 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 |
1680 DIAGONAL RD |
| City | WORTHINGTON |
| State | MN |
| Zip Code | 56187-1008 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548265994 | Fernando Escobar | Surgery | 1680 Diagonal Rd, Worthington, MN 56187-1008 | 2005-06-14 |
| 1518590058 | William James Rodney Nelson | Physician Assistant | 1680 Diagonal Rd, Worthington, MN 56187-1008 | 2020-02-12 |
| 1932755402 | Alettie Jane Lewis | Physician Assistant | 1680 Diagonal Rd, Worthington, MN 56187-1008 | 2019-08-12 |
| 1518433879 | Nicole Block | Nurse Practitioner | 1680 Diagonal Rd, Worthington, MN 56187 | 2018-10-15 |
| 1174005193 | Barbara Jean Pieske | Social Worker | 1680 Diagonal Rd, Worthington, MN 56187-1008 | 2018-09-06 |
| 1255880621 | Kelli Kristine Hinsch | Nurse Practitioner | 1680 Diagonal Rd, Worthington, MN 56187-1008 | 2016-09-27 |
| 1104371897 | Katie Talbott | Physician Assistant | 1680 Diagonal Rd, Worthington, MN 56187-1008 | 2016-08-23 |
| 1346693397 | Elena Canfield | Family Medicine | 1680 Diagonal Rd, Worthington, MN 56187-1008 | 2016-07-14 |
| 1679923973 | Jenna Wolfe | Internal Medicine | 1680 Diagonal Rd, Worthington, MN 56187-1008 | 2016-06-16 |
| 1235589797 | Erin Moeller | Social Worker | 1680 Diagonal Rd, Worthington, MN 56187-1008 | 2016-06-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316224363 | Paul Michael Carlson | Dentist | 507 South Shore Drive, Worthington, MN 56187 | 2011-11-04 |
| 1912216540 | Nobles County Jail | Clinic/Center | 1530 Airport Road, Worthington, MN 56187 | 2010-09-30 |
| 1306984539 | Edward Thomas Mcniece | Dentist | 1027 Second Ave, Worthington, MN 56187 | 2007-02-01 |
| 1053338780 | Diagnostic Radiologic Imaging Pa | Radiology | 1607 N Mcmillan St, Ste 1, Worthington, MN 56187 | 2006-07-17 |
| 1427014232 | Scott James Hoffman | Podiatrist | 1205 Ryans Road, Worthington, MN 56187 | 2006-04-21 |
| 1588654404 | Jason Coy Turner | Pharmacist | 511 10th St, Worthington, MN 56187 | 2005-10-22 |
| 1033423322 | Rachael R Dekker | Nurse Practitioner | 1018 6th Ave, Worthington, MN 56187 | 2010-07-29 |
| 1417196601 | Jonathan Gabriel Eli-phillips | Obstetrics & Gynecology | 1018 6th Ave, Worthington, MN 56187 | 2009-02-11 |
| 1174716245 | Sanford Clinic | Radiology | 1018 6th Ave, Worthington, MN 56187 | 2007-08-22 |
| 1144637943 | Molly Carrigg Greene Bishop | Music Therapist | 1635 Oakwood Dr, Worthington, MN 56187-1060 | 2014-07-14 |
| Find all providers in zip 56187 | ||||
| Taxonomy Code | 103T00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public. |
| Notes: Source: American Psychological Association [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740813898 | Carla Luciano Codani Hisatugo | Psychologist | 445 East Dublin Granville Rd., Worthington, OH 43085-3183 | 2020-02-18 |
| 1528506748 | Susan Jane Rowland | Psychologist | 1374 Abbeyhill Dr, Worthington, OH 43085-1731 | 2017-02-08 |
| 1154463297 | Shirley Jo Lange | Psychologist | 7100 N High St Ste 304, Worthington, OH 43085-2316 | 2007-02-13 |
| 1356407381 | Barbara Jane Reardon | Psychologist | 5701 N High Street, Suite 208, Worthington, OH 43085-3960 | 2006-12-27 |
| 1528126356 | Thelma D White | Psychologist | 6649 N High St Ste 106, Worthington, OH 43085-4004 | 2006-12-05 |
| 1871690537 | William Edward Collins | Psychologist | 5701 N High St, Suite 208, Worthington, OH 43085-3973 | 2006-09-17 |
| 1861436750 | James P. Reardon | Psychologist | 7550 Pingue Dr, Worthington, OH 43085-1714 | 2006-06-15 |
| 1083849145 | Sonya Nichole Slater | Psychologist | 6641 N High St, Suite 205, Worthington, OH 43085-4038 | 2009-05-19 |
| 1669658027 | Tracy L Sidesinger | Psychologist | 6797 N High St, Suite 306, Worthington, OH 43085-2533 | 2008-01-16 |
| 1053526608 | Sandra L. Shullman | Psychologist | 500 W Wilson Bridge Rd, Suite 30, Worthington, OH 43085-2238 | 2007-05-14 |
| Find all providers in WORTHINGTON | ||||
| City | WORTHINGTON |
| Zip Code | 56187 |
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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.