Sanford Clinic
Organization Active NPI Gynecology Physician · Sioux Falls, SD
NPI 1083645949 · NPPES record last updated Feb 11, 2025
Key facts
- NPI
- 1083645949
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Gynecology Physician 207VG0400X
- Legal business name
- SANFORD CLINIC
- Practice address
- 1500 W 22ND St Ste 402
Sioux Falls, SD 57105-1522 - Phone
- (605) 328-8750
- Fax
- (605) 328-8751
- NPI assigned
- Jul 6, 2006
- Organization subpart
- No
Authorized official
- Name
- Tony Lee Morrison
- Title
- Vice President, Revenue Cycle
- Phone
- (605) 328-8380
Other NPIs on the same Medicare enrollment 37
Practitioners 7
-
Kevin D Benson, MD
-
Carolyn Gilbertson, M.D.
-
Michelle Kutzke, MSN, WHNP-BC
-
Kelsey Schnepf, CNP
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (3 enrollments) in SD, MN, IA
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 |
| O20040115000943 | MN | Part B Supplier - Clinic/Group Practice | 0244143824 |
Receives reassigned benefits from 113 practitioners 30 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Prior Lake, MN; Slayton, MN; Tracy, MN; Walker, MN; Windom, MN; Worthington, MN; Stillwater, MN; Luverne, MN… |
| O20040216001158 | IA | Part B Supplier - Clinic/Group Practice | 0244143824 |
Receives reassigned benefits from 66 practitioners 25 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Sheldon, IA; Sioux City, IA; Rock Rapids, IA; Orange City, IA; Inwood, IA; Hawarden, IA |
National Provider Directory
Locations
1210 W 18th St
Ste 103
Sioux Falls, SD 57104
Phone (605) 328-1848
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gynecology Physician |
207VG0400X | Yes | ||
| Urology Physician |
208800000X |
Addresses
Primary practice location
1500 W 22ND St Ste 402
Sioux Falls, SD 57105-1522
Mailing address
PO Box 5074
Sioux Falls, SD 57117-5074
Phone (605) 328-7180
Other practice location 1
1500 W 22nd St
Suite 402
Sioux Falls, SD 57105-7702
Phone (605) 328-8750
Other practice location 2
450 Eastvold Ave
Ortonville, MN 56278-1252
Phone (605) 328-8750
Other practice location 3
118 N 7th Ave
Sheldon, IA 51201-1235
Phone (712) 324-5356
Other names
- Sanford Urogynecology and Pelvic Surgery Clinic
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service | Other | Cobius Healthcare Solutions |
Other providers in Sioux Falls, SD
- Ashley M. Sands
- Sanford Clinic
- Sanford Clinic
- Sanford Clinic
- Sanford Clinic
- Sanford Clinic
- Sanford Clinic
- Sanford Clinic
- Sanford Clinic
- Sanford Clinic
All providers in Sioux Falls, SD · Gynecology 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 Feb 11, 2025. 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.