Sanford Health Network

Organization Active NPI End-Stage Renal Disease (ESRD) Treatment Clinic/Center · Canby, MN

NPI 1245305697 · NPPES record last updated Nov 27, 2023

Key facts

NPI
1245305697
Entity type
Organization (NPI type 2)
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X
Legal business name
SANFORD HEALTH NETWORK
Practice address
112 Saint Olaf Ave S
Canby, MN 56220-1433
Phone
(507) 223-7277
Fax
(507) 223-7465
NPI assigned
Nov 21, 2006
Organization subpart
Yes
Parent organization (as reported)
SANFORD HEALTH NETWORK

Authorized official

Name
Tony Lee Morrison
Title
Vice President, Revenue Cycle
Phone
(605) 328-8380

Corporate family (same tax ID) 48

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

View all 48

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MN

All facility ownership & control disclosures 6

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Prairie Lakes Health Care System Inc
Watertown, SD · CCN 430005A
Hospital 5% Or Greater Direct Ownership Interest (100%) Oct 31, 2025
Windom Area Health
Windom, MN · CCN 241332
Hospital Operational/Managerial Control Jun 1, 1989
Windom Area Health
Windom, MN · CCN 24Z332
Hospital Operational/Managerial Control Jun 1, 1989
Sanford Webster Medical Center
Bristol, SD · CCN 435093
Skilled nursing facility Operational/Managerial Control
Adp of the SNF
Jul 1, 2000
Apr 7, 2025
Prairie Lakes Home Health
Watertown, SD · CCN 437019
Home health agency 5% Or Greater Direct Ownership Interest (100%) Oct 31, 2025
Prairie Lakes Hospice
Watertown, SD · CCN 431504
Hospice 5% Or Greater Direct Ownership Interest (100%) Oct 31, 2025

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20070716000752 MN Part a Provider - End-Stage Renal Disease Facility (ESRD) 6800707100 Practice locations: Canby, MN

National Provider Directory

Tax ID family
Sioux Valley Vermillion (49 organizations share this tax ID)
Part of
Sioux Valley Vermillion

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X Yes

Addresses

Primary practice location

112 Saint Olaf Ave S
Canby, MN 56220-1433

Mailing address

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

Other names

  • Sanford Canby Medical Center Doing business as

Electronic endpoints

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

Other providers in Canby, MN

All providers in Canby, MN · End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Minnesota

Sources for this page

Verify at the official NPI Registry.