NPIMap

Organization Active NPI

Sanford Health Network

Doing business as Sanford Clinic Vermillion

  • Family Medicine Physician
  • Vermillion, SD
National Provider Identifier
1013921733
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
SANFORD HEALTH NETWORK
Doing business as
Sanford Clinic Vermillion
Practice address
20 S Plum St
Vermillion, SD 57069-3346
Phone
(605) 624-9111
Fax
(605) 624-6636
NPI assigned
Jul 28, 2006
Last updated
Nov 27, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Tony Lee Morrison
Title
Vice President, Revenue Cycle
Phone
(605) 328-8380

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X
Registered NurseGroup: 193200000X MULTI-SPECIALTY GROUP 163W00000X
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X

Addresses

Primary practice location

20 S Plum St
Vermillion, SD 57069-3346

Mailing address

PO Box 5074
Sioux Falls, SD 57117-5074
Phone (605) 328-6585

Other names 1

  • Sanford Clinic Vermillion Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031111000266 SD Part B Supplier - Clinic/Group Practice 6800707100 Receives reassigned benefits from 489 practitioners
21 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Ipswich, SD; Webster, SD; Vermillion, SD; Sioux Falls, SD; Kimball, SD; Clear Lake, SD; Chamberlain, SD; Canton, SD…
O20040902001011 SD Part A Provider - Critical Access Hospital 6800707100 Receives reassigned benefits from 51 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Vermillion, SD

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1013921733. Details of each certification follow.

Hospital certification: CCN 431336

Legal name
SANFORD HEALTH NETWORK
Doing business as
SANFORD VERMILLION MEDICAL CENTER
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Nov 1, 2004
Last certification
Jun 22, 2023
Beds
25
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
Aug 15, 1985 in SD
Enrollment address
20 S Plum St
Vermillion, SD 57069-3346

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs on the same Medicare enrollment 19

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 19

Care Compare: Hospital

Medicare Care Compare
Listed as
Sanford Vermillion Medical CenterCCN 431336 · All quality measures
Type
Critical Access Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 23

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Mark Allen Lundeen Individual Corporate DirectorTrustee Dec 4, 2014
Marnie Lynn Ventling-Herrmann Individual Corporate DirectorTrustee Jan 1, 2022
Tony Lee Morrison Individual Corporate OfficerVP, Chief Revenue Cycle Officer Jan 19, 2020
W-2 Managing EmployeeVP, Chief Revenue Cycle Officer Jan 19, 2020
Michael Charles Wilde Individual W-2 Managing EmployeeChief Physician, Sioux Falls May 5, 2024
Brent Gerard Teiken Individual Corporate DirectorTrustee Jan 11, 2013
Jolyn Joy Munson Individual W-2 Managing EmployeeVP, Revenue Cycle Operations Apr 17, 2025
Dana James Dykhouse Individual Corporate DirectorTrustee Jan 1, 2024
Andrew Stewart North Individual Corporate OfficerSecretary Dec 1, 2015
Corporate DirectorTrustee Dec 1, 2015
Eric Lucas Vanden Hull Individual W-2 Managing EmployeeCfo, Sioux Falls Sep 25, 2022
Jon Allen Pociask Individual Corporate OfficerPresident, Coo, Health Network Aug 1, 2025
W-2 Managing EmployeePresident, Coo, Health Network Aug 1, 2025
Stephanie Marie Herseth Sandlin Individual Corporate DirectorTrustee Jan 1, 2024
William Joseph Gassen Individual Corporate OfficerPresident and Ceo Nov 24, 2020
Corporate DirectorPresident and Ceo Nov 24, 2020
George Joseph Brown Individual Corporate OfficerTreasurer Jan 1, 2025
Corporate DirectorTrustee Jan 1, 2025
Wesley Owen Engbrecht Individual Corporate DirectorTrustee Jan 1, 2021
Maureen Patricia McCausland Individual Corporate DirectorTrustee Jan 1, 2025
Sanford Organization, Fargo, ND Non-profit 5% Or Greater Indirect Ownership Interest Jul 20, 2010 100%
Thomas Richard Wenzel Individual Corporate DirectorTrustee Jan 1, 2025
David Jonathan Shulkin Individual Corporate DirectorTrustee Jan 1, 2024
Sanford Health Organization, Sioux Falls, SD Non-profit 5% Or Greater Direct Ownership Interest Aug 10, 2007 100%
Neil Leslie Gulsvig Individual Corporate DirectorTrustee Mar 28, 2019
Kevin Victor Schieffer Individual Corporate DirectorTrustee Jan 1, 2025
Lauris Nelson Molbert Individual Corporate DirectorTrustee Jan 1, 2021
Nicholas Wayne Olson Individual Corporate OfficerEvp,Cfo Apr 8, 2024
W-2 Managing Employee Apr 8, 2024

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 428

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 428

Affiliated clinicians 135

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 135

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701043200000",
    "number": "1013921733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5074",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571175074",
            "telephone_number": "605-328-6585",
            "fax_number": "605-328-7177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 S PLUM ST",
            "city": "VERMILLION",
            "state": "SD",
            "postal_code": "570693346",
            "telephone_number": "605-624-9111",
            "fax_number": "605-624-6636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANFORD HEALTH NETWORK",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-28",
        "last_updated": "2023-11-27",
        "certification_date": "2020-06-25",
        "status": "A",
        "authorized_official_last_name": "MORRISON",
        "authorized_official_first_name": "TONY",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "VICE PRESIDENT, REVENUE CYCLE",
        "authorized_official_telephone_number": "605-328-8380"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1068.1",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "2720 Dundee Rd # 302",
            "city": "Northbrook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600622609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Sanford Clinic Vermillion",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Sanford Clinic Vermillion",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Vermillion, SD

Sources for this page

Verify at the official NPI Registry.