NPIMap

Organization Active NPI

Sanford Medical Center Fargo

Doing business as Sanford Moorhead Clinic

  • Internal Medicine Physician
  • Moorhead, MN
National Provider Identifier
1609156934
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
SANFORD MEDICAL CENTER FARGO
Doing business as
Sanford Moorhead Clinic
Practice address
1301 8TH St S
Moorhead, MN 56560-3604
Phone
(701) 234-3200
NPI assigned
Aug 18, 2011
Last updated
Nov 27, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Authorized official

Name
Martha Leclerc
Title
Vice President
Phone
(701) 234-6248

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU
Internal Medicine Physician 207R00000X NU Primary

Addresses

Primary practice location

1301 8TH St S
Moorhead, MN 56560-3604

Mailing address

1301 8TH St S
Moorhead, MN 56560-3604
Phone (701) 234-3200

Other names 1

  • Sanford Moorhead Clinic Doing business as

Electronic endpoints 1

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

National Provider Directory

National Provider Directory
Tax ID family
St Lukes Hospital71 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 20

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1313625600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701043200000",
    "number": "1609156934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 8TH ST S",
            "city": "MOORHEAD",
            "state": "MN",
            "postal_code": "565603604",
            "telephone_number": "701-234-3200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 8TH ST S",
            "city": "MOORHEAD",
            "state": "MN",
            "postal_code": "565603604",
            "telephone_number": "701-234-3200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANFORD MEDICAL CENTER FARGO",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-18",
        "last_updated": "2023-11-27",
        "status": "A",
        "authorized_official_last_name": "LECLERC",
        "authorized_official_first_name": "MARTHA",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "701-234-6248"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "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 Moorhead Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Sanford Moorhead Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Moorhead, MN

Sources for this page

  • 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.