Organization Active NPI

Sanford Clinic

Doing business as Sanford Clinic Family Medicine Huron

  • Family Medicine Physician
  • Huron, SD
National Provider Identifier
1366635740
Registry record updated Dec 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
SANFORD CLINIC
Doing business as
Sanford Clinic Family Medicine Huron
Practice address
433 Kansas Ave SE
Huron, SD 57350-2561
Phone
(605) 352-2117
Fax
(605) 325-5513
NPI assigned
Aug 20, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2008

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

Authorized official

Name
Steve Goetsch
Title
Cfo
Phone
(605) 328-6940

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

433 Kansas Ave SE
Huron, SD 57350-2561

Mailing address

PO Box 5074
Sioux Falls, SD 57117-5074

Other names 1

  • Sanford Clinic Family Medicine Huron Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD

Enrollment records 1

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

National Provider Directory

National Provider Directory

Locations

433 Kansas Ave SE
Huron, SD 57350
Phone (605) 352-2117

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1187568000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1228262400000",
    "number": "1366635740",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "433 KANSAS AVE SE",
            "city": "HURON",
            "state": "SD",
            "postal_code": "573502561",
            "telephone_number": "605-352-2117",
            "fax_number": "605-325-5513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANFORD CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-20",
        "last_updated": "2008-12-03",
        "status": "A",
        "authorized_official_last_name": "GOETSCH",
        "authorized_official_first_name": "STEVE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "605-328-6940"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sanford Clinic Family Medicine Huron",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Huron, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2008; 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.