Soheil Souri

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

RL17362 Issued in ND

Practice address

3001 Sanford Pkwy
Thief River Falls, MN 56701-2700

Phone

(218) 681-4747

NPI assigned

Jul 12, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sanford Health Network NorthGroup PAC ID 8022206663, 114 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sanford Thief River Falls Medical Center Hospital, Thief River Falls, MN, CCN 241381

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Sanford Health Network North

  dba Sanford Health Southeast Campus

  • Multi-Specialty Clinic/Center
  • Thief River Falls, MN
  • NPI 1386047355
  Medicare reassignment Care Compare group NPD
• Sanford Health Network North

  dba Sanford Pharmacy Thief River Falls

  • Community/Retail Pharmacy
  • Thief River Falls, MN
  • NPI 1346423373
  NPD
• Sanford Health Network North

  dba Sanford Behavioral Health Center Clinic

  • Multi-Specialty Clinic/Center
  • Thief River Falls, MN
  • NPI 1861895906
  NPD
• Sanford Health Network North

  dba Sanford Thief River Falls Medical Center

  • Critical Access Hospital
  • Thief River Falls, MN
  • NPI 1043218753
  NPD (past)
• Sanford Health Network North

  dba Sanford Medical Center Hillsboro

  • Critical Access Hospital
  • Hillsboro, ND
  • NPI 1184725194
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Sanford Health Network North

  dba Sanford Thief River Falls Medical Center

  • Critical Access Hospital
  • Thief River Falls, MN
  • NPI 1043218753
  Care Compare affiliation
• Sanford Health Network North

  dba Sanford Behavioral Health Center

  • Psychiatric Hospital
  • Thief River Falls, MN
  • NPI 1790842466
  Care Compare affiliation
• Sanford Health Network North

  dba Sanford Behavioral Health Center Clinic

  • Multi-Specialty Clinic/Center
  • Thief River Falls, MN
  • NPI 1861895906

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1626048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721865600000",
    "number": "1073185856",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3001 SANFORD PKWY",
            "city": "THIEF RIVER FALLS",
            "state": "MN",
            "postal_code": "567012700",
            "telephone_number": "218-681-4747"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "737 Broadway N",
            "address_purpose": "LOCATION",
            "city": "Fargo",
            "state": "ND",
            "postal_code": "581024421",
            "country_code": "US",
            "telephone_number": "701-234-6076",
            "fax_number": "701-234-7230",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SOURI",
        "first_name": "SOHEIL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-07-12",
        "last_updated": "2024-07-25",
        "certification_date": "2024-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ND",
            "license": "RL17362",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deanna Kay Skaar, RD, LD
• Laura Ann Slaathaug Hawley
• Kyle Laurence Slaathaug, FNP-BC
• Ronald Maurice Smith, M.D.
• Miranda Elizabeth Solem, LADC
• Suresh Sreedharan, M.D.
• Terry Lee Storm, R.PH.
• Eiley Christina Sundby, M.S., CCC-SLP
• Chad Henry Tabatt, PT
• Irene V Tevlin, PMHNP-BC

• Family Medicine Physician in Thief River Falls, MN
• Providers in Thief River Falls, MN by specialty
• Family Medicine Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.