NPIMap

Organization Active NPI

Sanford Bismarck

Doing business as Sanford Fort Yates Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Fort Yates, ND
National Provider Identifier
1396828547
Registry record updated Jan 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
Legal business name
SANFORD BISMARCK
Doing business as
Sanford Fort Yates Dialysis
Practice address
#10 N River Rd
Fort Yates, ND 58538
Phone
(701) 854-7553
Fax
(701) 323-2801
NPI assigned
Oct 23, 2006
Last updated
Jan 23, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2025

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

Authorized official

Name
Michael R Schumacher
Title
Cfo
Phone
(701) 323-6130

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X Primary

Addresses

Primary practice location

#10 N River Rd
Fort Yates, ND 58538

Mailing address

300 N 7TH St
Bismarck, ND 58501-4439
Phone (701) 323-6000

Other identifiers 2

IdentifierTypeStateIssuer
01002MedicaidND
8623OtherNDBLUE CROSS FT YATES DIALY

Other names 1

  • Sanford Fort Yates Dialysis Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100526000472 ND Part A Provider - End-Stage Renal Disease Facility (ESRD) 9739098575 Practice locations: Fort Yates, ND

Other NPIs with the same Medicare PAC ID 9

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Robert a Vigesaa MD31 organizations share this tax ID, including this one

Other organizations with this tax ID 30

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

View all 30

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

  • Sanford West

    dba Sanford West Histocompatibility Laboratory

    • Clinical Medical Laboratory
    • Bismarck, ND
    • NPI 1700130515

    Member Of

    NPD member

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Wentz Living CenterNapoleon, ND, CCN 355102 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Jan 1, 2007
Jul 11, 2025

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

NPI Registry JSON

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737590400000",
    "number": "1396828547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 N 7TH ST",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585014439",
            "telephone_number": "701-323-6000",
            "fax_number": "701-323-5221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "#10 N RIVER RD",
            "city": "FORT YATES",
            "state": "ND",
            "postal_code": "58538",
            "telephone_number": "701-854-7553",
            "fax_number": "701-323-2801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANFORD BISMARCK",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-23",
        "last_updated": "2025-01-23",
        "certification_date": "2025-01-22",
        "status": "A",
        "authorized_official_last_name": "SCHUMACHER",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "701-323-6130"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01002",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS FT YATES DIALY",
            "identifier": "8623",
            "state": "ND"
        }
    ],
    "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 Fort Yates Dialysis",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Sanford Fort Yates Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fort Yates, ND

Sources for this page

Verify at the official NPI Registry.