Sanford Clinic
Organization Active NPI Clinic/Center · Sioux Falls, SD
NPI 1164069506 · NPPES record last updated Jun 29, 2020
Key facts
- NPI
- 1164069506
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Clinic/Center 261Q00000X
- Legal business name
- SANFORD CLINIC
- Practice address
- 2310 S Marion Rd Ste 140
Sioux Falls, SD 57106-1144 - Phone
- (605) 328-6690
- Fax
- (605) 312-9883
- NPI assigned
- Dec 4, 2019
- Organization subpart
- Yes
- Parent organization (as reported)
- SANFORD
Authorized official
- Name
- Tony Lee Morrison
- Title
- Vice President, Revenue Cycle
- Phone
- (605) 328-8380
Corporate family (same tax ID) 32
Practitioners 9
-
Mir Hyder Ali, MD
-
Victoria Dilts, PA-C
-
Jon Ryckman, MD
-
Kyla Stoops, NP
-
Emuejevoke Joseph Okoh, M.D.
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
- Tax ID family
- Sanford Clinic Ear Nose TH
Locations
2310 S Marion Rd
Ste 140
Sioux Falls, SD 57106
Phone (605) 328-6690
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinic/Center | 261Q00000X | Yes |
Addresses
Primary practice location
2310 S Marion Rd Ste 140
Sioux Falls, SD 57106-1144
Mailing address
PO Box 5074
Sioux Falls, SD 57117-5074
Phone (605) 328-6585
Other names
- Sanford Health Lake Lorraine Eye Clinic
Other providers in Sioux Falls, SD
- Sanford Clinic
- Sanford Clinic
- Sanford Clinic
- Sanford Clinic
- Sanford Clinic
- Sanford Clinic
- Sanford Clinic
- Sanford Clinic
- Sanford Clinic
- Sanford Clinic
All providers in Sioux Falls, SD · Clinic/Center 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 Jun 29, 2020. 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.