Sanford Clinic

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

SANFORD CLINIC

Doing business as

Sanford Medical Genetics Laboratory

Practice address

1321 W 22ND St
Sioux Falls, SD 57105-1502

Phone

(605) 404-4212

Fax

(605) 404-4351

NPI assigned

Mar 7, 2008

Last updated

Nov 27, 2023By the provider in NPPES

Organization subpart

No

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 1

Addresses

Other names 1

• Sanford Medical Genetics Laboratory Doing business as

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in SD

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Sanford Clinic33 organizations share this tax ID, including this one

Other organizations with this tax ID 32

Organizations that report the same tax identification number in the National Provider Directory.

• Sanford Clinic

  dba Sanford 69th & Louise Family Medicine

  • Family Medicine Physician
  • Sioux Falls, SD
  • NPI 1104255835
  NPD tax ID
• Sanford Clinic

  dba Sanford Health Lake Lorraine Eye Clinic

  • Clinic/Center
  • Sioux Falls, SD
  • NPI 1164069506
  NPD tax ID
• Sanford Clinic

  dba Sanford Clinic Breast Health Institute

  • Radiation Oncology Physician
  • Sioux Falls, SD
  • NPI 1174537799
  NPD tax ID
• Sanford Clinic

  dba Sanford Acute Care 69th & Minnesota Clinic

  • Family Medicine Physician
  • Sioux Falls, SD
  • NPI 1366450835
  NPD tax ID
• Sanford Clinic

  dba Sanford Children's 69th & Louise Clinic

  • Pediatrics Physician
  • Sioux Falls, SD
  • NPI 1386072569
  NPD tax ID
• Sanford Clinic

  dba Sanford Gynecologic Oncology Clinic

  • Gynecologic Oncology Physician
  • Sioux Falls, SD
  • NPI 1396089900
  NPD tax ID
• Sanford Clinic

  dba Sanford Children's Residency Clinic

  • Pediatrics Physician
  • Sioux Falls, SD
  • NPI 1437438306
  NPD tax ID
• Sanford Clinic

  dba Sanford 26th and Sycamore Family Medicine

  • Family Medicine Physician
  • Sioux Falls, SD
  • NPI 1447289343
  NPD tax ID
• Sanford Clinic

  dba Edith Sanford Breast Specialty Clinic

  • Family Medicine Physician
  • Sioux Falls, SD
  • NPI 1497163026
  NPD tax ID
• Sanford Clinic

  dba Sanford Health Lake Lorraine Eye Clinic

  • Eyewear Supplier
  • Sioux Falls, SD
  • NPI 1518599562
  NPD tax ID
• Sanford Clinic

  dba Sanford Clinic Gastroenterology

  • Gastroenterology Physician
  • Sioux Falls, SD
  • NPI 1518973221
  NPD tax ID
• Sanford Clinic

  dba Sanford Diabetes and Thyroid Clinic

  • Endocrinology, Diabetes & Metabolism Physician
  • Sioux Falls, SD
  • NPI 1578589677
  NPD tax ID

Practitioners 15

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.

• Backer Mahmoud Abdu, MD

  • Gastroenterology Physician
  • Sioux Falls, SD
  • NPI 1306366760
  NPD
• Charles A Broberg, DC, PA,

  • Physician Assistant
  • Sioux Falls, SD
  • NPI 1073672481
  NPD
• Jeremy Cauwels, MD

  • Hospitalist Physician
  • Sioux Falls, SD
  • NPI 1942243100
  NPD
• Joaquin Alberto Duarte Ow, MD

  • Internal Medicine Physician
  • Sioux Falls, SD
  • NPI 1336589779
  NPD
• Lauritz R Meyer, MD

  • Neonatal-Perinatal Medicine Physician
  • Sioux Falls, SD
  • NPI 1518126622
  NPD
• Jorge E Patino-Buelvas, M.D.

  • Family Medicine Physician
  • Sioux Falls, SD
  • NPI 1003040296
  NPD
• Todd W Persson, CNP

  • Family Nurse Practitioner
  • Sioux Falls, SD
  • NPI 1164811618
  NPD
• Nathan Alan Peterson, FNP-C

  • Nurse Practitioner
  • Sioux Falls, SD
  • NPI 1659971927
  NPD
• G Patrick Riedmann Jr, PA-C

  • Physician Assistant
  • Sioux Falls, SD
  • NPI 1750471058
  NPD
• Shawn Michael Vuong, M.D.

  • Neurological Surgery Physician
  • Sioux Falls, SD
  • NPI 1861758856
  NPD
• William F Waltz, MD

  • Pediatric Cardiology Physician
  • Sioux Falls, SD
  • NPI 1649226986
  NPD
• Kelly Rose Wharton, CNP

  • Family Nurse Practitioner
  • Sioux Falls, SD
  • NPI 1376216648
  NPD

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

{
    "created_epoch": "1204848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701043200000",
    "number": "1346410115",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1321 W 22ND ST",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571051502",
            "telephone_number": "605-404-4212",
            "fax_number": "605-404-4351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANFORD CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-07",
        "last_updated": "2023-11-27",
        "certification_date": "2020-06-30",
        "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": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "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",
            "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 Medical Genetics Laboratory",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sanford Clinic (Sanford Clinic Family Medicine Sanford Campus MB1)
• Sanford Clinic (Sanford Clinic Nephrology)
• Sanford Clinic (Sanford Obstetrics and Gynecology Clinic)
• Sanford Clinic (Sanford Clinic Acute Care 34th and Kiwanis)
• Sanford Clinic (Sanford Health Pathology Clinic)
• Sanford Clinic (Sanford Clinic Radiation Oncology)
• Sanford Clinic (Sanford Acute Care 69th & Minnesota Clinic)
• Sanford Clinic (Sanford Eye Center & Optical)
• Sanford Clinic (Sanford Children's 69th & Louise Clinic)
• Sanford Clinic (Sanford Gynecologic Oncology Clinic)

• Clinical Medical Laboratory in Sioux Falls, SD
• Providers in Sioux Falls, SD by specialty
• Clinical Medical Laboratory in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.