Sanford Health of Northern Minnesota
Organization Active NPI Certified Registered Nurse Anesthetist · Bemidji, MN
NPI 1285708438 · NPPES record last updated Jun 30, 2011
Key facts
- NPI
- 1285708438
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Certified Registered Nurse Anesthetist 367500000X
- License
- 330837 (MN)
- Legal business name
- SANFORD HEALTH OF NORTHERN MINNESOTA
- Practice address
- 1300 Anne St NW
Bemidji, MN 56601-5103 - Phone
- (218) 751-5430
- Fax
- (218) 333-5566
- NPI assigned
- Nov 20, 2006
- Organization subpart
- No
Authorized official
- Name
- Mr. Jon F. Bergquist
- Title
- Business Office Manager
- Phone
- (218) 333-5514
Other NPIs on the same Medicare enrollment 11
Corporate family (same tax ID) 22
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20041025000442 | MN | Part B Supplier - Clinic/Group Practice | 5597725168 |
Receives reassigned benefits from 644 practitioners 12 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Bemidji, MN; International Falls, MN; Kelliher, MN; Minneapolis, MN; Dover, MN; Osage, MN; Park Rapids, MN; Perham, MN… |
National Provider Directory
- Tax ID family
- North Country Health SE
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist |
367500000X | 330837 | MN | Yes |
Addresses
Primary practice location
1300 Anne St NW
Bemidji, MN 56601-5103
Mailing address
1300 Anne St NW
Bemidji, MN 56601-5103
Phone (218) 751-5430
Other names
- Sanford Bemidji
Other providers in Bemidji, MN
- Sanford Health of Northern Minnesota
- Sanford Health of Northern Minnesota
- Sanford Health of Northern Minnesota
- Sanford Health of Northern Minnesota
- Sanford Health of Northern Minnesota
- Sanford Health of Northern Minnesota
- Sanford Health of Northern Minnesota
- Sanford Health of Northern Minnesota
- Sanford Health of Northern Minnesota
- Sanford Health of Northern Minnesota
All providers in Bemidji, MN · Certified Registered Nurse Anesthetist in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 30, 2011. 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.