Active NPI
Sanford School of Medicine the University of SD Clinical Virolog Lab
- Clinical Medical Laboratory
- Sioux Falls, SD
National Provider Identifier
1487747044
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Medical Laboratory
- Legal business name
- SANFORD SCHOOL OF MEDICINE THE UNIVERSITY OF SD CLINICAL VIROLOG LAB
- Practice address
- 2501 W 22ND St
Sioux Falls, SD 57105-1305 - Phone
- (605) 333-5399
- Fax
- (605) 333-5399
- NPI assigned
- Oct 2, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Michael R Koch, M.D.
- Title
- Dept. Chair
- Phone
- (605) 336-3230
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Medical Laboratory | 291U00000X | SD | Primary |
Addresses
Primary practice location
2501 W 22ND St
Sioux Falls, SD 57105-1305
Mailing address
1400 W 22ND St
Sioux Falls, SD 57105-1505
Phone (605) 357-1380
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5580870 | Medicaid | SD | |
| 0077920 | Other | SD | BLUECROSS AND BLUESHIELD |
National Provider Directory
National Provider Directory- Tax ID family
- Sanford School of Medicine the University of SD Clinical Virolog Lab
Other organizations with this tax ID 2
Organizations that report the same tax identification number in the National Provider Directory.
-
- Clinical Medical Laboratory
- Rapid City, SD
- NPI 1437242096
-
- Family Medicine Physician
- Sioux Falls, SD
- NPI 1942236096
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159747200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1487747044",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1400 W 22ND ST",
"city": "SIOUX FALLS",
"state": "SD",
"postal_code": "571051505",
"telephone_number": "605-357-1380",
"fax_number": "605-357-1548"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2501 W 22ND ST",
"city": "SIOUX FALLS",
"state": "SD",
"postal_code": "571051305",
"telephone_number": "605-333-5399",
"fax_number": "605-333-5399"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SANFORD SCHOOL OF MEDICINE THE UNIVERSITY OF SD CLINICAL VIROLOG LAB",
"organizational_subpart": "NO",
"enumeration_date": "2006-10-02",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "KOCH",
"authorized_official_first_name": "MICHAEL",
"authorized_official_middle_name": "R",
"authorized_official_title_or_position": "DEPT. CHAIR",
"authorized_official_telephone_number": "605-336-3230",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "291U00000X",
"taxonomy_group": "",
"desc": "Clinical Medical Laboratory",
"state": "SD",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "5580870",
"state": "SD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUECROSS AND BLUESHIELD",
"identifier": "0077920",
"state": "SD"
}
],
"endpoints": [],
"other_names": []
}Other providers in Sioux Falls, SD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.