Sanford Health Network
Organization Active NPI Critical Access Hospital · Canton, SD
NPI 1265718571 · NPPES record last updated Nov 6, 2020
Key facts
- NPI
- 1265718571
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Critical Access Hospital 282NC0060X
- License
- 51569 (SD)
- Legal business name
- SANFORD HEALTH NETWORK
- Practice address
- 440 N Hiawatha Dr
Canton, SD 57013-5800 - Phone
- (605) 987-2621
- Fax
- (605) 987-5631
- NPI assigned
- Nov 1, 2011
- 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
Owners & managing parties with NPI records 1
-
Michael C Wilde, M.D.
Other NPIs on the same Medicare enrollment 28
Related certifications (CCN) 2
Practitioners 26
-
Danette Rae Baumann, P.A.
-
David W. Bursack, DNP-FNP
-
Vickie Lynne Ernst, PA-C
-
Rosa Eyton, NP
-
Jean M Johnson, CRNA
-
Michael Ryan Johnson, C.R.N.A.
-
Vivek Joseph, MD
-
Jason L Meister, CRNA
-
Marian S Petrasko, M.D.
-
Rachel Potter, PA-C
-
James Alan Ruley, PA-C
-
Wade Robert Sendelbach, MSN, APRN, CNP
-
Elizabeth Sutton, MD
-
Meghan Jeane Torgerson, FNP-C
-
Shawn Michael Vuong, M.D.
-
Kayelyn J. Wagner, M.D.
-
Dawn R Bucher, CNP
-
Beta Jo Hamon, MD
-
Jose Luis Henao, MD
-
Curtis Peery, MD
Affiliated clinicians 69
-
Adeem Abdulwahab, M.D
-
Sameer Ahmed, MD
-
Lee Thomas Austin, M.D.
-
Clint Benge, M.D.
-
Scott L. Boyens, MD
-
Dana Brandys, D.O.
-
Cari Ann Folkens, CNP
-
Ashley Frost, CNP
-
Laurie C. Gromer, CNP
-
Mark Heidenreich, M.D.
-
Krista M Hoyme, DO
-
Bradley Eugene Iverson, M.D.
-
Jesseca Lynn Kast, CNP
-
Jennifer L Klein, MD
-
Sarah Boschee Krush, NP-C
-
Eric A Larson, M.D.
-
Rebecca M Leonard, CNP
-
Robert Michael Leonard, PA-C
Medicare Care Compare: Hospital
- Listed as
- Sanford Canton-Inwood Medical Center - Cah
- Type
- Critical Access Hospitals
- Ownership
- Voluntary non-profit - Private
- Medicare certification status
- Active
- Emergency services
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (3 enrollments) in SD, IA
Hospital certification: CCN 431333
- Legal name
- SANFORD HEALTH NETWORK
- Doing business as
- SANFORD CANTON INWOOD MEDICAL CENTER
- Certification status
- Active
- Provider type (POS)
- Hospital – Critical access hospital
- Participating since
- Dec 1, 2003
- Last certification
- Aug 11, 2022
- Beds
- 11
- Ownership / control type
- Private (not for profit)
- Most recent change of ownership
- Jan 1, 2009 (1 total)
- Organization structure
- Corporation · Non-profit
- Incorporated
- Aug 15, 1985 in SD
- Enrollment address
- 440 N Hiawatha Dr
Canton, SD 57013-5800
All disclosed owners & managing parties 23
| Name | Role | Since | Share |
|---|---|---|---|
| Mark Allen Lundeen |
Corporate Director |
Dec 4, 2014 | |
| Marnie Lynn Ventling-Herrmann |
Corporate Director |
Jan 1, 2022 | |
| Tony Lee Morrison |
W-2 Managing Employee |
Jan 19, 2020 | |
| Michael Charles Wilde |
W-2 Managing Employee |
May 5, 2024 | |
| Brent Gerard Teiken |
Corporate Director | Dec 4, 2014 | |
| Jolyn Joy Munson |
W-2 Managing Employee |
Apr 17, 2025 | |
| Dana James Dykhouse |
Corporate Director |
Jan 1, 2024 | |
| Andrew Stewart North |
Corporate Officer |
Dec 1, 2015 | |
| Corporate Director |
Dec 1, 2015 | ||
| Eric Lucas Vanden Hull |
W-2 Managing Employee |
Sep 25, 2022 | |
| Jon Allen Pociask |
Corporate Officer |
Aug 1, 2025 | |
| W-2 Managing Employee |
Aug 1, 2025 | ||
| Stephanie Marie Herseth Sandlin |
Corporate Director |
Jan 1, 2024 | |
| William Joseph Gassen |
Corporate Officer |
Nov 23, 2020 | |
| Corporate Director |
Nov 23, 2020 | ||
| George Joseph Brown |
Corporate Officer |
Jan 1, 2025 | |
| Corporate Director |
Jan 1, 2025 | ||
| Wesley Owen Engbrecht |
Corporate Director |
Jan 1, 2021 | |
| Maureen Patricia McCausland |
Corporate Director |
Jan 1, 2025 | |
| Sanford |
5% Or Greater Indirect Ownership Interest | Nov 2, 2009 | 100% |
| Thomas Richard Wenzel |
Corporate Director |
Jan 1, 2025 | |
| David Jonathan Shulkin |
Corporate Director |
Jan 1, 2024 | |
| Sanford Health |
5% Or Greater Direct Ownership Interest | Jul 1, 2008 | 100% |
| Neil Leslie Gulsvig |
Corporate Director |
Mar 28, 2019 | |
| Kevin Victor Schieffer |
Corporate Director |
Jan 1, 2025 | |
| Lauris Nelson Molbert |
Corporate Director |
Jan 1, 2021 | |
| Nicholas Wayne Olson |
W-2 Managing Employee |
Apr 8, 2024 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031111000266 | SD | Part B Supplier - Clinic/Group Practice | 6800707100 |
Receives reassigned benefits from 489 practitioners 21 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Ipswich, SD; Webster, SD; Vermillion, SD; Sioux Falls, SD; Kimball, SD; Clear Lake, SD; Chamberlain, SD; Canton, SD… |
| O20040324000654 | IA | Part B Supplier - Clinic/Group Practice | 6800707100 |
Receives reassigned benefits from 72 practitioners 13 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Sanborn, IA; Sheldon, IA; Sibley, IA; Primghar, IA; Rock Rapids, IA; Boyden, IA; Hartley, IA; Lake Park, IA… |
| O20081202000394 | SD | Part a Provider - Critical Access Hospital | 6800707100 |
Receives reassigned benefits from 24 practitioners 2 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Canton, SD |
National Provider Directory
- Part of
- Sioux Valley Vermillion
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | 51569 | SD | |
| Critical Access Hospital | 282NC0060X | 51569 | SD | Yes |
| Nurse Practitioner |
363L00000X | 51569 | SD |
Addresses
Primary practice location
440 N Hiawatha Dr
Canton, SD 57013-5800
Mailing address
PO Box 5074
Sioux Falls, SD 57117-5074
Phone (605) 328-6585
Other practice location 1
303 E Jefferson St
Inwood, IA 51240-7766
Phone (712) 753-4401
Other names
- Sanford Canton Clinic
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service | Other | Cobius Healthcare Solutions |
Other providers in Canton, SD
- Patricia Renee Ramse
- George Daniel Rath
- Kendra Rae Rauk
- Eugene R Regier
- Sanford Health Network
- Sanford Health Network
- Sanford Health Network
- Sanford Health Network
- Bailey Schroeder
- Gordon Schulte
All providers in Canton, SD · Critical Access Hospital 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 Nov 6, 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.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.