Sanford Health of Northern Minnesota

Primary specialty

Radiation Oncology Clinic/CenterTaxonomy code 261QX0203X

Legal business name

SANFORD HEALTH OF NORTHERN MINNESOTA

Practice address

1233 34TH St NW
Bemidji, MN 56601-5112

Phone

(218) 333-5000

Fax

(701) 234-2045

NPI assigned

Jan 2, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Martha K Leclerc

Title

VP

Phone

(701) 234-6248

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Sanford Bemidji Doing business as

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

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1320278400000",
    "number": "1316004369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 4TH ST N",
            "address_2": "PO BOX 2010",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581220605",
            "telephone_number": "218-333-5000",
            "fax_number": "701-234-2045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1233 34TH ST NW",
            "city": "BEMIDJI",
            "state": "MN",
            "postal_code": "566015112",
            "telephone_number": "218-333-5000",
            "fax_number": "701-234-2045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANFORD HEALTH OF NORTHERN MINNESOTA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-02",
        "last_updated": "2011-11-03",
        "status": "A",
        "authorized_official_last_name": "LECLERC",
        "authorized_official_first_name": "MARTHA",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "VP",
        "authorized_official_telephone_number": "701-234-6248"
    },
    "taxonomies": [
        {
            "code": "261QX0203X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Oncology, Radiation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "939646200",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MNBC",
            "identifier": "1C19HME",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sanford Bemidji",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• 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
• Radiation Oncology Clinic/Center in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.