NPIMap

Organization Active NPI

Sanford Clinic

Doing business as Sanford Health Cancer Center

  • Radiation Oncology Physician
  • Worthington, MN
National Provider Identifier
1174716245
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
Legal business name
SANFORD CLINIC
Doing business as
Sanford Health Cancer Center
Practice address
1018 6TH Ave
Worthington, MN 56187
Phone
(507) 372-3600
Fax
(507) 372-3620
NPI assigned
Aug 22, 2007
Last updated
Nov 27, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X NU Primary

Addresses

Primary practice location

1018 6TH Ave
Worthington, MN 56187

Mailing address

PO Box 5074
Sioux Falls, SD 57117-5074
Phone (605) 328-6585

Other practice location 1

1018 6th Ave
Worthington, MN 56187
Phone (507) 372-3600

Other names 1

  • Sanford Health Cancer Center Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, IA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
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

Other NPIs on the same Medicare enrollment 37

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 37

National Provider Directory

National Provider Directory

Locations

1018 6th Ave
Worthington, MN 56187
Phone (507) 343-6100

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1187740800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701043200000",
    "number": "1174716245",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1018 6TH AVE",
            "city": "WORTHINGTON",
            "state": "MN",
            "postal_code": "56187",
            "telephone_number": "507-372-3600",
            "fax_number": "507-372-3620"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1018 6th Ave",
            "address_purpose": "LOCATION",
            "city": "Worthington",
            "state": "MN",
            "postal_code": "56187",
            "country_code": "US",
            "telephone_number": "507-372-3600",
            "fax_number": "507-372-3620",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SANFORD CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-22",
        "last_updated": "2023-11-27",
        "certification_date": "2020-06-29",
        "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": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1068.1",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "2720 Dundee Rd # 302",
            "city": "Northbrook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600622609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Sanford Health Cancer Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Worthington, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.