Sanford Clinic

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

SANFORD CLINIC

Doing business as

Sanford Clinic Family Medicine Brandon

Practice address

1105 E Holly Blvd
Brandon, SD 57005-1359

Phone

(605) 582-5820

Fax

(605) 582-5823

NPI assigned

Jul 25, 2006

Last updated

Jun 26, 2020By the provider in NPPES

Organization subpart

No

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 3

Addresses

Other names 1

• Sanford Clinic Family Medicine Brandon Doing business as

Medicare fee-for-service enrollment

Enrolled in SD

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 9

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.

• Christopher Boschee, DO

  • Family Medicine Physician
  • Sioux Falls, SD
  • NPI 1295992154
  NPD
• Tenelle Jenee Bunnell, CNM

  • Advanced Practice Midwife
  • Sioux Falls, SD
  • NPI 1437893567
  NPD
• Stephanie Deck, FNP-BC

  • Nurse Practitioner
  • Sioux Falls, SD
  • NPI 1841776424
  NPD
• Robin Leigh Horstman, WHNP

  • Nurse Practitioner
  • Sioux Falls, SD
  • NPI 1164859427
  NPD
• Meredith Lynn Kemper, MD

  • Obstetrics & Gynecology Physician
  • Sioux Falls, SD
  • NPI 1215145784
  NPD
• Rose Melvin, CNM

  • Advanced Practice Midwife
  • Sioux Falls, SD
  • NPI 1700285913
  NPD
• Alison Dawn Neufeld, CNM

  • Advanced Practice Midwife
  • Sioux Falls, SD
  • NPI 1811495856
  NPD
• Michael Cackovic, MD

  • Maternal & Fetal Medicine Physician
  • Columbus, OH
  • NPI 1962485045
  NPD
• Michael Charles Gordon, MD

  • Maternal & Fetal Medicine Physician
  • Murray, UT
  • NPI 1609842053

  Family Medicine

  NPD

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1593129600000",
    "number": "1073536066",
    "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": "605-582-5823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1105 E HOLLY BLVD",
            "city": "BRANDON",
            "state": "SD",
            "postal_code": "570051359",
            "telephone_number": "605-582-5820",
            "fax_number": "605-582-5823"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANFORD CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-25",
        "last_updated": "2020-06-26",
        "certification_date": "2020-06-26",
        "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": "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": [],
    "other_names": [
        {
            "organization_name": "Sanford Clinic Family Medicine Brandon",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Sanford Clinic Family Medicine Brandon",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jami Lynn Ray, MA, CCC/SLP
• Matthew Reese, ED.S
• Melissa Rogers
• Brad Rotert, PHARMD
• Sage Counseling Services LLC
• Sanford Medical Center (Lewis Drug #9)
• Jeremy Sanford, MSW
• Elle Schanzenbach
• Julia Ann Marie Schlekeway, DPT
• Cacey Schmidt, NP

• Family Medicine Physician in Brandon, SD
• Providers in Brandon, SD by specialty
• Family Medicine Physician in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.