Sanford Health Network

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

Legal business name

SANFORD HEALTH NETWORK

Doing business as

Pioneer Medical Center

Practice address

803 S Greene St
Rock Rapids, IA 51246-1948

Phone

(712) 472-3716

Fax

(712) 472-2878

NPI assigned

Nov 8, 2006

Last updated

Nov 27, 2023By the provider in NPPES

Organization subpart

Yes

Parent organization

SANFORD HEALTH NETWORKAs reported in NPPES

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

Authorized official

Name

Mr. Joel Mason Gustafson

Title

Administrator

Phone

(712) 472-3716

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Pioneer Medical Center Doing business as

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Part of

Canby Community Health

Change-of-ownership history 1

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

• Avera McKennan

  dba Avera Medical Group Rock Rapids

  • Rural Health Clinic/Center
  • Rock Rapids, IA
  • NPI 1003389206

  Sold to, 2019-05-01

  CMS change of ownership

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

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701043200000",
    "number": "1245300557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "803 S GREENE ST",
            "city": "ROCK RAPIDS",
            "state": "IA",
            "postal_code": "512461948",
            "telephone_number": "712-472-3716",
            "fax_number": "712-472-2878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "803 S GREENE ST",
            "city": "ROCK RAPIDS",
            "state": "IA",
            "postal_code": "512461948",
            "telephone_number": "712-472-3716",
            "fax_number": "712-472-2878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANFORD HEALTH NETWORK",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SANFORD HEALTH NETWORK",
        "enumeration_date": "2006-11-08",
        "last_updated": "2023-11-27",
        "status": "A",
        "authorized_official_last_name": "GUSTAFSON",
        "authorized_official_first_name": "JOEL",
        "authorized_official_middle_name": "MASON",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "712-472-3716",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0638700",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0250498",
            "state": "IA"
        }
    ],
    "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": "Pioneer Medical Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Pioneer Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Rock River Eye Care, PC
• Rebecca Lynn Roemen, PA-C
• Michael Lee Roetman, OD
• Melissa Marlene Sandbulte, ATC, DPT
• Sanford Clinic (Sanford Health Rock Rapids Clinic)
• Sanford Home Health
• Sanford Medical Center (Lewis Family Drug #61)
• David James Springer, M.D.
• Stonebridge Suites of Rock Rapids, LLC
• Jason Stubbe, PHARMD

• Rural Health Clinic/Center in Rock Rapids, IA
• Providers in Rock Rapids, IA by specialty
• Rural Health Clinic/Center in Iowa

• 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; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.