NPIMap

Organization Active NPI

Sanford Health Network

Doing business as Sanford Canton Clinic

  • Critical Access Hospital
  • Canton, SD
National Provider Identifier
1265718571
Registry record updated Nov 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
License
51569 Issued in SD
Legal business name
SANFORD HEALTH NETWORK
Doing business as
Sanford Canton Clinic
Practice address
440 N Hiawatha Dr
Canton, SD 57013-5800
Phone
(605) 987-2621
Fax
(605) 987-5631
NPI assigned
Nov 1, 2011
Last updated
Nov 6, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
SANFORD HEALTH NETWORKAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 6, 2020

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X 51569 SD
Critical Access Hospital 282NC0060X 51569 SD Primary
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 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 1

  • Sanford Canton Clinic Doing business as

Electronic endpoints 1

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD, IA3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
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

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1265718571. Details of each certification follow.

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
CorporationNon-profit
Incorporated
Aug 15, 1985 in SD
Enrollment address
440 N Hiawatha Dr
Canton, SD 57013-5800

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs on the same Medicare enrollment 28

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

View all 28

Care Compare: Hospital

Medicare Care Compare
Listed as
Sanford Canton-Inwood Medical Center - CahCCN 431333 · All quality measures
Type
Critical Access Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Part of
Canby Community Health

Locations

440 N Hiawatha Dr
Canton, SD 57013
Phone (605) 987-2621

Ownership & related parties

All disclosed owners & managing parties 23

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Mark Allen Lundeen Individual Corporate DirectorTrustee Dec 4, 2014
Marnie Lynn Ventling-Herrmann Individual Corporate DirectorTrustee Jan 1, 2022
Tony Lee Morrison Individual W-2 Managing EmployeeVP, Chief Revenue Cycle Officer Jan 19, 2020
Michael Charles Wilde Individual W-2 Managing EmployeeChief Physician, Sioux Falls May 5, 2024
Brent Gerard Teiken Individual Corporate Director Dec 4, 2014
Jolyn Joy Munson Individual W-2 Managing EmployeeVice President, Revenue Cycle Opera Apr 17, 2025
Dana James Dykhouse Individual Corporate DirectorTrustee Jan 1, 2024
Andrew Stewart North Individual Corporate OfficerTrustee, Secretary Dec 1, 2015
Corporate DirectorTrustee, Secretary Dec 1, 2015
Eric Lucas Vanden Hull Individual W-2 Managing EmployeeChief Financial Officer, Sioux Fall Sep 25, 2022
Jon Allen Pociask Individual Corporate OfficerPresident, Coo Aug 1, 2025
W-2 Managing EmployeePresident, Coo Aug 1, 2025
Stephanie Marie Herseth Sandlin Individual Corporate DirectorTrustee Jan 1, 2024
William Joseph Gassen Individual Corporate OfficerTrustee, Ceo Nov 23, 2020
Corporate DirectorTrustee, Ceo Nov 23, 2020
George Joseph Brown Individual Corporate OfficerTrustee, Treasurer Jan 1, 2025
Corporate DirectorTrustee, Treasurer Jan 1, 2025
Wesley Owen Engbrecht Individual Corporate DirectorBoard of Trustes Jan 1, 2021
Maureen Patricia McCausland Individual Corporate DirectorTrustee Jan 1, 2025
Sanford Organization, Fargo, ND Non-profit 5% Or Greater Indirect Ownership Interest Nov 2, 2009 100%
Thomas Richard Wenzel Individual Corporate DirectorTrustee Jan 1, 2025
David Jonathan Shulkin Individual Corporate DirectorTrustee Jan 1, 2024
Sanford Health Organization, Sioux Falls, SD Non-profit 5% Or Greater Direct Ownership Interest Jul 1, 2008 100%
Neil Leslie Gulsvig Individual Corporate DirectorTrustee Mar 28, 2019
Kevin Victor Schieffer Individual Corporate DirectorTrustee Jan 1, 2025
Lauris Nelson Molbert Individual Corporate DirectorBoard of Trustees Jan 1, 2021
Nicholas Wayne Olson Individual W-2 Managing EmployeeChief Financial Officer Apr 8, 2024

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 26

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.

View all 26

Affiliated clinicians 69

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 69

NPI Registry JSON

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

{
    "created_epoch": "1320105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1604620800000",
    "number": "1265718571",
    "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",
            "fax_number": "605-328-6512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "440 N HIAWATHA DR",
            "city": "CANTON",
            "state": "SD",
            "postal_code": "570135800",
            "telephone_number": "605-987-2621",
            "fax_number": "605-987-5631"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "303 E Jefferson St",
            "address_purpose": "LOCATION",
            "city": "Inwood",
            "state": "IA",
            "postal_code": "512407766",
            "country_code": "US",
            "telephone_number": "712-753-4401",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SANFORD HEALTH NETWORK",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SANFORD HEALTH NETWORK",
        "enumeration_date": "2011-11-01",
        "last_updated": "2020-11-06",
        "certification_date": "2020-11-06",
        "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": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "SD",
            "license": "51569",
            "primary": false
        },
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "SD",
            "license": "51569",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": "SD",
            "license": "51569",
            "primary": false
        }
    ],
    "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",
            "affiliationName": "Cobius Healthcare Solutions",
            "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 Canton Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Canton, SD

Sources for this page

Verify at the official NPI Registry.