Sanford Clinic
Organization Active NPI Preventive Medicine/Occupational Environmental Medicine Physician · Sheldon, IA
NPI 1639282940 · NPPES record last updated Nov 27, 2023
Key facts
- NPI
- 1639282940
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Preventive Medicine/Occupational Environmental Medicine Physician 2083P0500X
- Legal business name
- SANFORD CLINIC
- Practice address
- 118 N 7TH Ave
Sheldon, IA 51201-1235 - Phone
- (605) 328-9300
- Fax
- (605) 328-9301
- NPI assigned
- Aug 17, 2006
- Organization subpart
- No
Authorized official
- Name
- Tony Lee Morrison
- Title
- Vice President, Revenue Cycle
- Phone
- (605) 328-8380
Other NPIs on the same Medicare enrollment 24
Practitioners 15
-
Sally Jo McMahon, ARNP
-
Marc A Capitano, MD
-
Jocelyn K Dahl, PA
-
Katarina Kay Dirkson, FNP-C
-
Megan Hinrichsen, NP-C
-
Aaron Stoick, CNP
-
Gary Timmerman, MD
-
Jessica R White, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in SD, IA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031110000532 | SD | Part B Supplier - Clinic/Group Practice | 0244143824 |
Receives reassigned benefits from 941 practitioners This NPI is an additional NPI on the enrollment |
| O20040216001158 | IA | Part B Supplier - Clinic/Group Practice | 0244143824 |
Receives reassigned benefits from 66 practitioners 25 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Sheldon, IA; Sioux City, IA; Rock Rapids, IA; Orange City, IA; Inwood, IA; Hawarden, IA |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse |
163W00000X | |||
| Family Medicine Physician |
207Q00000X | |||
| Preventive Medicine/Occupational Environmental Medicine Physician |
2083P0500X | Yes | ||
| Occupational Medicine Physician |
2083X0100X | |||
| Diagnostic Radiology Physician |
2085R0202X | |||
| Occupational Therapy Assistant |
224Z00000X | |||
| Radiologic Technologist |
247100000X | |||
| Physician Assistant |
363A00000X | |||
| Nurse Practitioner |
363L00000X | |||
| Clinical Nurse Specialist |
364S00000X |
Addresses
Primary practice location
118 N 7TH Ave
Sheldon, IA 51201-1235
Mailing address
PO Box 5074
Sioux Falls, SD 57117-5074
Phone (605) 328-7180
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 281988100 | Medicaid | MN |
Other names
- Sanford Health Acute Care & Walk-In
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service | Other |
Other providers in Sheldon, IA
- Dana Rohrs
- Cindy Kay Roth
- Ruby Chiropractic Clinic, P.C.
- Roger A. Ruby
- Ashley Sandersfeld
- Sanford Health Network
- Sanford Health Network
- Sanford Health Network
- Sanford Health Network
- Sanford Health Network
All providers in Sheldon, IA · Preventive Medicine/Occupational Environmental Medicine Physician in Iowa
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 27, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.