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Organization Active NPI

Sanford Clinic

Doing business as Sanford Obstetrics and Gynecology Clinic

  • Obstetrics & Gynecology Physician
  • Sioux Falls, SD
National Provider Identifier
1306869227
Registry record updated Feb 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
SANFORD CLINIC
Doing business as
Sanford Obstetrics and Gynecology Clinic
Practice address
1500 W 22ND St
Ste 301
Sioux Falls, SD 57105-1503
Phone
(605) 328-7700
Fax
(605) 328-7775
NPI assigned
Jul 25, 2006
Last updated
Feb 19, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2025

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 12

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU
Nurse Practitioner 363L00000X NU
Psychologist 103T00000X NU
Registered Nurse 163W00000X NU
Internal Medicine Physician 207R00000X NU
Obstetrics & Gynecology Physician 207V00000X NU Primary
Maternal & Fetal Medicine Physician 207VM0101X NU
Diagnostic Ultrasound Physician 2085U0001X NU
Surgical Oncology Physician 2086X0206X NU
Pathology Technician 246R00000X NU
Radiologic Technologist 247100000X NU
Genetic Counselor (M.S.) 170300000X NU

Addresses

Primary practice location

1500 W 22ND St
Ste 301
Sioux Falls, SD 57105-1503

Mailing address

PO Box 5074
Sioux Falls, SD 57117-5074
Phone (605) 328-8307

Other practice location 1

5019 S Western Ave Ste 100
Sioux Falls, SD 57108-5096
Phone (605) 328-9700

Other practice location 2

922 22nd Ave S
Brookings, SD 57006-2830
Phone (605) 697-1900

Other practice location 3

803 S Greene St
Rock Rapids, IA 51246-1948
Phone (712) 472-3716

Other practice location 4

3006 Tower Rd
Rapid City, SD 57701-5392
Phone (605) 343-7295

Other practice location 5

1500 W 22nd St Ste 301
Sioux Falls, SD 57105-1503
Phone (605) 328-7700

Other practice location 6

901 4th St NW
Watertown, SD 57201-1558
Phone (605) 328-7700

Other identifiers 2

IdentifierTypeStateIssuer
0562025MedicaidIA
827927600MedicaidMN

Other names 1

  • Sanford Obstetrics and Gynecology Clinic Doing business as

Medicare participation

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

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20031110000532 SD Part B Supplier - Clinic/Group Practice 0244143824 Receives reassigned benefits from 941 practitioners
This NPI is an additional NPI on the enrollment
O20040115000943 MN Part B Supplier - Clinic/Group Practice 0244143824 Receives reassigned benefits from 113 practitioners
30 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Prior Lake, MN; Slayton, MN; Tracy, MN; Walker, MN; Windom, MN; Worthington, MN; Stillwater, MN; Luverne, MN…
O20040216001158 IA Part B Supplier - Clinic/Group Practice 0244143824 Receives reassigned benefits from 66 practitioners
25 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Sheldon, IA; Sioux City, IA; Rock Rapids, IA; Orange City, IA; Inwood, IA; Hawarden, IA

Other NPIs on the same Medicare enrollment 37

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

View all 37

National Provider Directory

National Provider Directory

Locations

5019 S Western Ave
Ste 100
Sioux Falls, SD 57108
Phone (605) 328-9700

Practitioners & affiliated clinicians

Practitioners 22

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 22

NPI Registry JSON

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739923200000",
    "number": "1306869227",
    "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": "605-328-8307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 W 22ND ST",
            "address_2": "STE 301",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571051503",
            "telephone_number": "605-328-7700",
            "fax_number": "605-328-7775"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5019 S Western Ave Ste 100",
            "address_purpose": "LOCATION",
            "city": "Sioux Falls",
            "state": "SD",
            "postal_code": "571085096",
            "country_code": "US",
            "telephone_number": "605-328-9700",
            "fax_number": "605-328-9709",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "922 22nd Ave S",
            "address_purpose": "LOCATION",
            "city": "Brookings",
            "state": "SD",
            "postal_code": "570062830",
            "country_code": "US",
            "telephone_number": "605-697-1900",
            "fax_number": "605-697-1919",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "803 S Greene St",
            "address_purpose": "LOCATION",
            "city": "Rock Rapids",
            "state": "IA",
            "postal_code": "512461948",
            "country_code": "US",
            "telephone_number": "712-472-3716",
            "fax_number": "712-472-2878",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3006 Tower Rd",
            "address_purpose": "LOCATION",
            "city": "Rapid City",
            "state": "SD",
            "postal_code": "577015392",
            "country_code": "US",
            "telephone_number": "605-343-7295",
            "fax_number": "605-343-0138",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1500 W 22nd St Ste 301",
            "address_purpose": "LOCATION",
            "city": "Sioux Falls",
            "state": "SD",
            "postal_code": "571051503",
            "country_code": "US",
            "telephone_number": "605-328-7700",
            "fax_number": "605-328-7775",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "901 4th St NW",
            "address_purpose": "LOCATION",
            "city": "Watertown",
            "state": "SD",
            "postal_code": "572011558",
            "country_code": "US",
            "telephone_number": "605-328-7700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SANFORD CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-25",
        "last_updated": "2025-02-19",
        "certification_date": "2025-02-19",
        "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": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207VM0101X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2085U0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Ultrasound",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2086X0206X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Oncology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "246R00000X",
            "taxonomy_group": "",
            "desc": "Technician, Pathology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "247100000X",
            "taxonomy_group": "",
            "desc": "Radiologic Technologist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "170300000X",
            "taxonomy_group": "",
            "desc": "Genetic Counselor, MS",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0562025",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "827927600",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sanford Obstetrics and Gynecology Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sioux Falls, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.