Sanford Medical Center Fargo
Organization Active NPI Community Based Hospice Care Agency · Fargo, ND
NPI 1366092801 · NPPES record last updated Dec 30, 2025
Key facts
- NPI
- 1366092801
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community Based Hospice Care Agency 251G00000X
- Legal business name
- SANFORD MEDICAL CENTER FARGO
- Practice address
- 801 Broadway N
Fargo, ND 58102-3641 - Phone
- (701) 234-7550
- Fax
- (701) 234-7559
- NPI assigned
- Sep 17, 2019
- Organization subpart
- Yes
- Parent organization (as reported)
- SANFORD
Authorized official
- Name
- Tony Lee Morrison
- Title
- Vice President, Revenue Cycle
- Phone
- (605) 328-8380
Owners & managing parties with NPI records 1
Corporate family (same tax ID) 24
Facilities with the same owner 31
Affiliated clinicians 7
-
Sudhir K Chavour, MD
-
Lindsey Jo Dahl, M.D
-
Rajendra Potluri, M.D.
-
Dinesh Bande, M.D.
Medicare Care Compare: Hospice
- Listed as
- Sanford Fargo Hospice
- Ownership
- Non-Profit
- Certified
- Feb 26, 2020
- Medicare certification status
- Active
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ND
Hospice certification: CCN 351519
- Legal name
- SANFORD MEDICAL CENTER FARGO
- Doing business as
- SANFORD FARGO HOSPICE
- Certification status
- Active
- Provider type (POS)
- Hospice
- Participating since
- Feb 26, 2020
- Last certification
- Feb 26, 2020
- Ownership / control type
- Non-Profit - Other
- Organization structure
- Corporation · Non-profit
- Incorporated
- Aug 15, 1985 in ND
- Enrollment address
- 801 Broadway N
Fargo, ND 58102-3641
All disclosed owners & managing parties 24
| Name | Role | Since | Share |
|---|---|---|---|
| Mark Allen Lundeen |
Corporate Director |
Dec 4, 2014 | |
| Marnie Lynn Ventling-Herrmann |
Corporate Officer |
Jan 1, 2024 | |
| Corporate Director |
Jan 1, 2022 | ||
| Tony Lee Morrison |
W-2 Managing Employee |
Jan 19, 2020 | |
| Brent Gerard Teiken |
Corporate Director |
Jul 3, 2012 | |
| Susan Drake Jarvis |
W-2 Managing Employee |
Jan 1, 2023 | |
| Kristin Kaye Herrmann |
W-2 Managing Employee |
Apr 24, 2022 | |
| Jolyn Joy Munson |
W-2 Managing Employee |
Apr 17, 2025 | |
| Dana James Dykhouse |
Corporate Director |
Jan 1, 2024 | |
| Andrew Stewart North |
Corporate Director |
Jan 1, 2017 | |
| Stephanie Marie Herseth Sandlin |
Corporate Director |
Jan 1, 2024 | |
| William Joseph Gassen |
Corporate Officer |
Nov 23, 2020 | |
| Corporate Director |
Nov 23, 2020 | ||
| Douglas Marlin Griffin |
W-2 Managing Employee |
Sep 25, 2022 | |
| George Joseph Brown |
Corporate Officer |
Jan 1, 2025 | |
| Wesley Owen Engbrecht |
Corporate Director |
Jan 1, 2021 | |
| Maureen Patricia McCausland |
Corporate Director |
Jan 1, 2025 | |
| Sanford |
5% Or Greater Direct Ownership Interest | Jul 15, 2011 | 100% |
| Tiffany L Lawrence |
Corporate Officer |
Mar 3, 2022 | |
| W-2 Managing Employee |
Mar 3, 2022 | ||
| Thomas Richard Wenzel |
Corporate Director |
Jan 1, 2025 | |
| David Jonathan Shulkin |
Corporate Director |
Jan 1, 2024 | |
| Neil Leslie Gulsvig |
Corporate Director |
Mar 28, 2019 | |
| Kevin Victor Schieffer |
Corporate Director |
Jan 1, 2025 | |
| Lauris Nelson Molbert |
Corporate Officer |
Jan 1, 2024 | |
| Corporate Director |
Jan 1, 2021 | ||
| Nicholas Wayne Olson |
W-2 Managing Employee |
Apr 8, 2024 | |
| Sanford North |
5% Or Greater Direct Ownership Interest | Mar 1, 2011 | 100% |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20191205002960 | ND | Part a Provider - Hospice | 8426967803 | Practice locations: Fargo, ND |
National Provider Directory
- Tax ID family
- Bemidji Same Day Surgery
Locations
820 4th St N
Fargo, ND 58102
Phone (701) 234-6161
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Based Hospice Care Agency | 251G00000X | Yes | ||
| Inpatient Hospice | 315D00000X |
Addresses
Primary practice location
801 Broadway N
Fargo, ND 58102-3641
Mailing address
PO Box 2168
Fargo, ND 58107-2168
Phone (605) 328-6585
Other practice location 1
801 Broadway N
Fargo, ND 58102-3641
Phone (701) 234-5264
Other names
- Sanford Fargo Hospice
- Sanford Fargo Hospice House
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service | Other | Cobius Healthcare Solutions |
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All providers in Fargo, ND · Community Based Hospice Care Agency in North Dakota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 30, 2025. 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.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.