NPIMap

Organization Active NPI

Sanford Clinic North

  • Family Medicine Physician
  • New York Mills, MN
National Provider Identifier
1154343176
Registry record updated Nov 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
SANFORD CLINIC NORTH
Doing business as
Perham Health New York Mills Clinic
Practice address
20 W Centennial 84 Drive
New York Mills, MN 56567-0364
Phone
(218) 385-1800
Fax
(218) 385-1830
NPI assigned
Jul 25, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2011

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

Authorized official

Name
Martha K Leclerc
Title
VP
Phone
(701) 234-6248

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Corneal and Contact Management OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152WC0802X
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208600000X

Addresses

Primary practice location

20 W Centennial 84 Drive
New York Mills, MN 56567-0364

Mailing address

PO Box D
20 W Centennial 84 Drive
New York Mills, MN 56567-0364
Phone (218) 385-1800

Other identifiers 1

IdentifierTypeStateIssuer
463217600MedicaidMN

Other names 1

  • Perham Health New York Mills Clinic Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1320624000000",
    "number": "1154343176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX D",
            "address_2": "20 W CENTENNIAL 84 DRIVE",
            "city": "NEW YORK MILLS",
            "state": "MN",
            "postal_code": "565670364",
            "telephone_number": "218-385-1800",
            "fax_number": "218-385-1830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 W CENTENNIAL 84 DRIVE",
            "city": "NEW YORK MILLS",
            "state": "MN",
            "postal_code": "565670364",
            "telephone_number": "218-385-1800",
            "fax_number": "218-385-1830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANFORD CLINIC NORTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-25",
        "last_updated": "2011-11-07",
        "status": "A",
        "authorized_official_last_name": "LECLERC",
        "authorized_official_first_name": "MARTHA",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "VP",
        "authorized_official_telephone_number": "701-234-6248"
    },
    "taxonomies": [
        {
            "code": "152WC0802X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "463217600",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Perham Health New York Mills Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in New York Mills, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.