Sanford Clinic

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

SANFORD CLINIC

Doing business as

Sanford Children's Clinic Mitchell

Practice address

1200 S Burr St Ste B
Mitchell, SD 57301-4585

Phone

(605) 292-0695

Fax

(605) 292-0699

NPI assigned

Aug 14, 2007

Organization subpart

No

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 2

Addresses

Other names 1

• Sanford Children's Clinic Mitchell Doing business as

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in SD

Enrollment records 1

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Michelle L. Baack, MD

  • Pediatrics Physician
  • Sioux Falls, SD
  • NPI 1316911266
  NPD
• Brooke Elizabeth Jones, M.D.

  • Pediatrics Physician
  • Sioux Falls, SD
  • NPI 1851690051
  NPD
• Douglas William Lynch, M.D.

  • Clinical Pathology/Laboratory Medicine Physician
  • Sioux Falls, SD
  • NPI 1174767842
  NPD
• Jessica Leigh Olcott, MD

  • Hospitalist Physician
  • Sioux Falls, SD
  • NPI 1891131512

  Pediatrics

  NPD
• Tiffany Reitsma, CNP

  • Family Nurse Practitioner
  • Sioux Falls, SD
  • NPI 1275963506
  NPD
• Douglas Dean Wallin, OD

  • Optometrist
  • Sioux Falls, SD
  • NPI 1114923034
  NPD
• Michael J Shinners, MD

  • Otolaryngology Physician
  • Fargo, ND
  • NPI 1447395512
  NPD

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

{
    "created_epoch": "1187049600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701043200000",
    "number": "1386836377",
    "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": "1200 S BURR ST STE B",
            "city": "MITCHELL",
            "state": "SD",
            "postal_code": "573014585",
            "telephone_number": "605-292-0695",
            "fax_number": "605-292-0699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANFORD CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-14",
        "last_updated": "2023-11-27",
        "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": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "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 Children's Clinic Mitchell",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Sanford Children's Clinic Mitchell",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jayne Rubendall, ED.S.
• Kim Rubendall
• Rural Health Care, Inc
• Jodi Esther Salazar, CSW-PIP MSW
• Tara Linn Sandoval
• Sanford Clinic
• Sanford Medical Center
• Sanford Medical Center
• Alexis Schaffer, DPT
• Leonard Scheich

• Pediatrics Physician in Mitchell, SD
• Providers in Mitchell, SD by specialty
• Pediatrics Physician 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.