NPIMap

Organization Active NPI

Sanford Clinic North

Doing business as Sanford North Fargo Clinic

  • Family Medicine Physician
  • Fargo, ND
National Provider Identifier
1194751594
Registry record updated Nov 2, 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
Sanford North Fargo Clinic
Practice address
2601 Broadway N
Fargo, ND 58102-6704
Phone
(701) 234-2900
Fax
(701) 234-2996
NPI assigned
Jun 25, 2006
Last updated
Nov 2, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 2, 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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

2601 Broadway N
Fargo, ND 58102-6704

Mailing address

2601 Broadway N
Fargo, ND 58102-6704
Phone (701) 234-2900

Other identifiers 1

IdentifierTypeStateIssuer
027813100MedicaidMN

Other names 1

  • Sanford North Fargo Clinic Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Sanford Clinic North31 organizations share this tax ID, including this one

Other organizations with this tax ID 30

Organizations that report the same tax identification number in the National Provider Directory.

View all 30

Locations

2601 Broadway N
Fargo, ND 58102
Phone (701) 234-2482

NPI Registry JSON

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

{
    "created_epoch": "1151193600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1320192000000",
    "number": "1194751594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2601 BROADWAY N",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581026704",
            "telephone_number": "701-234-2900",
            "fax_number": "701-234-2996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601 BROADWAY N",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581026704",
            "telephone_number": "701-234-2900",
            "fax_number": "701-234-2996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANFORD CLINIC NORTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-25",
        "last_updated": "2011-11-02",
        "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": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "027813100",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sanford North Fargo Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fargo, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 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.