Sanford Clinic

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

SANFORD CLINIC

Doing business as

Sanford Children's Clinic Duncan

Practice address

2502 W. Elk Ave.
Duncan, OK 73533

Phone

(580) 354-5700

NPI assigned

Jun 9, 2009

Last updated

Sep 11, 2009By the provider in NPPES

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 1

Addresses

Other identifiers 1

Other names 1

• Sanford Children's Clinic Duncan Doing business as

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Sanford Clinic

  dba Sanford Virtual Health Services

  • Diagnostic Radiology Physician
  • Fargo, ND
  • NPI 1306641345

  O20090820000233

  Same enrollment

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

{
    "created_epoch": "1244505600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1252627200000",
    "number": "1740416395",
    "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": "2502 W. ELK AVE.",
            "city": "DUNCAN",
            "state": "OK",
            "postal_code": "73533",
            "telephone_number": "580-354-5700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANFORD CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-09",
        "last_updated": "2009-09-11",
        "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": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200253670A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sanford Children's Clinic Duncan",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mark Rosekelly, D.O
• Stephanie M Rosekelly, CNM, APN
• Dana Patricia Rubio Rosero
• Jessica Diane Ryans
• Steven Emmanuel Saltiel, ARNP
• Robert Drew Schick, DDS
• Heather L Schooling
• Melissa K Schreckengost, APRN-CNP
• Terry J Schreiner, D.D.S.
• Emily J Schrick, DNP, APRN, FNP-C

• Pediatrics Physician in Duncan, OK
• Providers in Duncan, OK by specialty
• Pediatrics Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2009; 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.