Sanford Clinic
Organization Active NPI Family Medicine Physician · Sioux Falls, SD
NPI 1013948439 · NPPES record last updated Nov 27, 2023
Key facts
- NPI
- 1013948439
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- SANFORD CLINIC
- Practice address
- 6110 S Minnesota Avenue
Sioux Falls, SD 57108 - Phone
- (605) 328-5800
- Fax
- (605) 328-5814
- NPI assigned
- Jul 5, 2006
- Organization subpart
- No
Authorized official
- Name
- Tony Lee Morrison
- Title
- Vice President, Revenue Cycle
- Phone
- (605) 328-8380
Practitioners 20
-
Eric Dean Curtis, APRN, CNP
-
Jordyn Agnes Hofer, CNP
-
Alyssa Hoffman, APRN, CNP
-
Jennifer L Houwman, PA-C
-
Courtney L Hubert, PA-C
-
Rachel Lynde, NP-C
-
Jill Marie Melby, CNP
-
Jeffry Meyer, MD
-
Regan M Norgaard, PA-C
-
Abrea Ann Roark, M.D.
-
David A Thomas, M.D.
-
Jenna Wickersham, D.O.
-
Peter Joachim Niemann, M.D.
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 43D2064830 | Sanford Health Campus Clinic 33Rd & Grange | Provider-performed microscopy | Aug 27, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in SD
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031110000532 | SD | Part B Supplier - Clinic/Group Practice | 0244143824 |
Receives reassigned benefits from 941 practitioners This NPI is an additional NPI on the enrollment |
National Provider Directory
Locations
3401 W 49th St
Sioux Falls, SD 57106
Phone (605) 328-1850
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse |
163W00000X | |||
| Family Medicine Physician |
207Q00000X | Yes | ||
| Radiologic Technologist |
247100000X |
Addresses
Primary practice location
6110 S Minnesota Avenue
Sioux Falls, SD 57108
Mailing address
PO Box 5074
Sioux Falls, SD 57117-5074
Phone (605) 328-6585
Other practice location 1
2001 S Summit Ave
Sioux Falls, SD 57197-0001
Phone (605) 274-4500
Other names
- Sanford Clinic Family Medicine 69th & Minnesota
- Sanford Health Campus Clinic 33rd & Grange
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service | Other |
Other providers in Sioux Falls, SD
- Malcom S Sanders
- Morgan Joy Sandersfeld
- Divyajot Singh Sandhu
- Dalynn Marie Sandine
- Ashley M. Sands
- Sanford Clinic
- Sanford Clinic
- Sanford Clinic
- Sanford Clinic
- Sanford Clinic
All providers in Sioux Falls, SD · Family Medicine Physician in South Dakota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 27, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.