NPIMap

Organization Active NPI

Sanford Clinic

  • Hematology & Oncology Physician
  • Sioux Falls, SD
National Provider Identifier
1770518037
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
Legal business name
SANFORD CLINIC
Practice address
1309 W 17TH St
Ste 101
Sioux Falls, SD 57104-8805
Phone
(605) 328-8000
Fax
(605) 328-8001
NPI assigned
Jul 12, 2006
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
Tony Lee Morrison
Title
Vice President, Revenue Cycle
Phone
(605) 328-8380

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Hematology & Oncology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RH0003X Primary
Clinical Nurse SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 364S00000X
Oncology Clinical Nurse SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 364SX0200X

Addresses

Primary practice location

1309 W 17TH St
Ste 101
Sioux Falls, SD 57104-8805

Mailing address

PO Box 5074
Sioux Falls, SD 57117-5074
Phone (605) 328-6585

Other practice location 1

20 S Plum St
Vermillion, SD 57069-3346
Phone (605) 328-8000

Other identifiers 2

IdentifierTypeStateIssuer
0537886MedicaidIA
281988100MedicaidMN

Other names 1

  • Sanford Cancer Center - Oncology Clinic 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 SD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031110000532 SD Part B Supplier - Clinic/Group Practice 0244143824 Receives reassigned benefits from 941 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 16

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701043200000",
    "number": "1770518037",
    "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",
            "telephone_number": "605-328-6585",
            "fax_number": "605-328-7177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1309 W 17TH ST",
            "address_2": "STE 101",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571048805",
            "telephone_number": "605-328-8000",
            "fax_number": "605-328-8001"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "20 S Plum St",
            "address_purpose": "LOCATION",
            "city": "Vermillion",
            "state": "SD",
            "postal_code": "570693346",
            "country_code": "US",
            "telephone_number": "605-328-8000",
            "fax_number": "605-328-8001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SANFORD CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-12",
        "last_updated": "2023-11-27",
        "certification_date": "2020-07-06",
        "status": "A",
        "authorized_official_last_name": "MORRISON",
        "authorized_official_first_name": "TONY",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "VICE PRESIDENT, REVENUE CYCLE",
        "authorized_official_telephone_number": "605-328-8380"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "364S00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Clinical Nurse Specialist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "364SX0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Clinical Nurse Specialist, Oncology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0537886",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "281988100",
            "state": "MN"
        }
    ],
    "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 Cancer Center - Oncology Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Sanford Cancer Center - Oncology Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Nov 27, 2023; 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.