NPIMap

Sanford Health of Northern Minnesota

Organization Active NPI Internal Medicine Physician · Bemidji, MN

NPI 1780628149 · NPPES record last updated May 8, 2026

Key facts

NPI
1780628149
Entity type
Organization (NPI type 2)
Primary specialty
Internal Medicine Physician 207R00000X
Legal business name
SANFORD HEALTH OF NORTHERN MINNESOTA
Practice address
1233 34TH St NW
Bemidji, MN 56601-5112
Phone
(218) 333-5000
Fax
(218) 333-5360
NPI assigned
Jun 16, 2006
Organization subpart
No

Authorized official

Name
Tony Lee Morrison
Title
Vice President, Revenue Cycle
Phone
(605) 328-8380

Owners & managing parties with NPI records 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Other NPIs on the same Medicare enrollment 13

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

Other NPIs with the same Medicare PAC ID 20

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Facilities connected through Provider of Services related, parent or unit certification numbers.

Practitioners 635

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

View all 635

Affiliated clinicians 485

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 485

Medicare Care Compare: Hospital

Listed as
Sanford Bemidji Medical Center CCN 240100
Overall star rating
★★★★☆ 4 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
Active (Provider of Services file)
Emergency services
Yes

Source: Medicare Care Compare.

Medicare participation

Medicare fee-for-service enrollment
Enrolled (14 enrollments) in MN, TX, OH, ND, MI, SD, GA, IA, WI, MO, MT, LA

Hospital certification: CCN 240100

Legal name
SANFORD HEALTH OF NORTHERN MINNESOTA
Doing business as
SANFORD BEMIDJI MEDICAL CENTER
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Mar 6, 2015
Beds
118
Ownership / control type
Private (not for profit)
Organization structure
Corporation · Non-profit
Enrollment address
1300 Anne St NW
Bemidji, MN 56601-5103
Main/Primary Hospital Location
Hospital subgroups
Acute care

All disclosed owners & managing parties 24

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Mark Allen Lundeen
Individual 		Corporate Director
Trustee		 Jan 1, 2014
Jason Joseph Caron
Individual 		W-2 Managing Employee
President		 Jan 1, 2026
Marnie Lynn Ventling-Herrmann
Individual 		Corporate Director
Trustee		 Jan 1, 2022
Tony Lee Morrison
Individual 		W-2 Managing Employee
VP, Chief Revenue Cycle Officer		 Jan 19, 2020
Daniel George Hoody
Individual 		W-2 Managing Employee
Chief Physician, Medical Officer		 Oct 9, 2023
Brent Gerard Teiken
Individual 		Corporate Director
Trustee		 Jul 3, 2012
Jolyn Joy Munson
Individual 		W-2 Managing Employee Apr 17, 2025
Dana James Dykhouse
Individual 		Corporate Director
Trustee		 Jan 1, 2024
Andrew Stewart North
Individual 		Corporate Director
Trustee		 Jan 1, 2017
Renee Marie Axtman
Individual 		W-2 Managing Employee
Chief Operations Officer		 Jan 1, 2026
Stephanie Marie Herseth Sandlin
Individual 		Corporate Director
Trustee		 Jan 1, 2024
William Joseph Gassen
Individual 		Corporate Director
Trustee, Ceo		 Nov 23, 2020
George Joseph Brown
Individual 		Corporate Director
Trustee		 Jan 1, 2025
Wesley Owen Engbrecht
Individual 		Corporate Director
Trustee		 Jan 1, 2021
Maureen Patricia McCausland
Individual 		Corporate Director
Trustee		 Jan 1, 2025
Sanford
Organization · Fargo, ND
Corporation, Non-profit 		5% Or Greater Indirect Ownership Interest Mar 1, 2011 100%
Lisa Sue Miller
Individual 		W-2 Managing Employee Sep 9, 2019
Thomas Richard Wenzel
Individual 		Corporate Director
Trustee		 Jan 1, 2025
David Jonathan Shulkin
Individual 		Corporate Director
Trustee		 Jan 1, 2024
Neil Leslie Gulsvig
Individual 		Corporate Director
Trustee		 Mar 28, 2019
Kevin Victor Schieffer
Individual 		Corporate Director
Trustee		 Jan 1, 2025
Lauris Nelson Molbert
Individual 		Corporate Director
Trustee		 Jan 1, 2021
Nicholas Wayne Olson
Individual 		W-2 Managing Employee
Cfo		 Apr 8, 2024
Sanford North
Organization · Bismarck, ND
Corporation, Non-profit 		5% Or Greater Direct Ownership Interest Mar 1, 2011 100%

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20041025000442 MN Part B Supplier - Clinic/Group Practice 5597725168 Receives reassigned benefits from 644 practitioners
12 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Bemidji, MN; International Falls, MN; Kelliher, MN; Minneapolis, MN; Dover, MN; Osage, MN; Park Rapids, MN; Perham, MN…
O20041026001020 MN Part a Provider - Hospital 5597725168 2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Walker, MN; Cass Lake, MN; Blackduck, MN; Bemidji, MN
O20150602000945 MN Part B Supplier - Clinic/Group Practice 5597725168 Receives reassigned benefits from 15 practitioners
2 other NPIs on this enrollment
Practice locations: Bemidji, MN; Tenstrike, MN; Park Rapids, MN; Moose Lake, MN; Dover, MN; Cass Lake, MN; Bagley, MN; Andover, MN
O20230608000871 TX Part B Supplier - Clinic/Group Practice 5597725168 Receives reassigned benefits from 3 practitioners
Practice locations: Allen, TX; Heath, TX; Rockwall, TX; Spring, TX
O20230616000249 OH Part B Supplier - Clinic/Group Practice 5597725168 Receives reassigned benefits from 1 practitioner
Practice locations: Cincinnati, OH
O20230915002288 ND Part B Supplier - Clinic/Group Practice 5597725168 Receives reassigned benefits from 2 practitioners
Practice locations: Fargo, ND; West Fargo, ND
O20231011001773 MI Part B Supplier - Clinic/Group Practice 5597725168 Receives reassigned benefits from 3 practitioners
Practice locations: Kalamazoo, MI; Trenton, MI; Macomb, MI
O20231012002520 SD Part B Supplier - Clinic/Group Practice 5597725168 Receives reassigned benefits from 2 practitioners
Practice locations: Watertown, SD; Avon, SD
O20240523001013 GA Part B Supplier - Clinic/Group Practice 5597725168 Receives reassigned benefits from 1 practitioner
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Buford, GA
O20240606000137 IA Part B Supplier - Clinic/Group Practice 5597725168 Receives reassigned benefits from 1 practitioner
Practice locations: Coralville, IA
O20251015003285 WI Part B Supplier - Clinic/Group Practice 5597725168 Receives reassigned benefits from 1 practitioner
Practice locations: Wausau, WI
O20260109000301 MO Part B Supplier - Clinic/Group Practice 5597725168 Receives reassigned benefits from 1 practitioner
Practice locations: Joplin, MO
O20260408001000 MT Part B Supplier - Clinic/Group Practice 5597725168 Receives reassigned benefits from 1 practitioner
Practice locations: Great Falls, MT
O20260505000100 LA Part B Supplier - Clinic/Group Practice 5597725168 Receives reassigned benefits from 1 practitioner
Practice locations: New Orleans, LA

National Provider Directory

Locations

116 3rd St NW
Bemidji, MN 56601
Phone (218) 333-2220

3525 Pne RDG Nwave
Bemidji, MN 56601
Phone (218) 333-5665

2017 Net Way NW
Bemidji, MN 56601
Phone (218) 333-4745

1705 Anne St NW
Ste 58
Bemidji, MN 56601

81 1st St NW
#A
Blackduck, MN 56630
Phone (218) 835-7700

109 Grove Ave S
Ste 1
Park Rapids, MN 56470
Phone (218) 731-7266

110 7th St W
#1705
Park Rapids, MN 56470
Phone (218) 699-3121

2900 E Broadway Ave
Ste 1
Bismarck, ND 58501
Phone (701) 221-9997

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 207L00000X
Family Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 207Q00000X
Internal Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 207R00000X Yes
Obstetrics & Gynecology Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 207V00000X
Orthopaedic Surgery Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 207X00000X
Anatomic Pathology Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 207ZP0101X
Surgery Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 208600000X
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X

Addresses

Primary practice location

1233 34TH St NW
Bemidji, MN 56601-5112

Mailing address

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

Other practice location 1

4450 Aspenway
Duluth, MN 55810-9733
Phone (218) 333-5000

Other practice location 2

1720 Highway 59 S
Thief River Falls, MN 56701-4331
Phone (218) 683-3937

Other practice location 3

116 3rd St NW
Bemidji, MN 56601-3102
Phone (218) 333-2220

Other practice location 4

110 7th St W
Park Rapids, MN 56470-1872
Phone (218) 699-3121

Other practice location 5

1009 Hollinger St
Park Rapids, MN 56470-1300
Phone (218) 252-6608

Other practice location 6

1000 Anne St NW
Bemidji, MN 56601-5109
Phone (218) 751-0220

Other practice location 7

1705 Anne St NW
Bemidji, MN 56601-6151
Phone (218) 333-5000

Other practice location 8

1000 Coney St W
Perham, MN 56573-2102
Phone (218) 347-1200

Other practice location 9

506 Beltrami Ave NW
Bemidji, MN 56601-3010
Phone (218) 751-2020

Other practice location 10

1656 Central St W
Bagley, MN 56621-4357
Phone (218) 694-2384

Other practice location 11

81 1st St NW
Blackduck, MN 56630-2228
Phone (218) 835-4222

Other practice location 12

801 Broadway N
Fargo, ND 58102-3641
Phone (701) 234-2000

Other practice location 13

1611 Anne St NW
Bemidji, MN 56601-5114
Phone (218) 333-5000

Other practice location 14

4179 8th St SW
Backus, MN 56435-2340
Phone (218) 333-5000

Other practice location 15

801 Broadway N
Fargo, ND 58102-3641
Phone (701) 234-2000

Other practice location 16

4003 Crosley Ave
Cincinnati, WI 54212
Phone (218) 333-5000

Other practice location 17

992 Starlight Pl
Rockwall, TX 75087-2294
Phone (218) 333-5000

Other practice location 18

219 Grant Utley Ave NW
Cass Lake, MN 56633-3619
Phone (218) 335-2559

Other practice location 19

1300 Anne St NW
Bemidji, MN 56601-5103
Phone (218) 333-5000

Other practice location 20

3717 Pine Ridge Ave NW
Bemidji, MN 56601-5106
Phone (218) 333-4527

Other practice location 21

1580 Highway 71
International Falls, MN 56649-2131
Phone (218) 598-5665

Other practice location 22

100 Huntsinger Ave
Park Rapids, MN 56470-1326
Phone (218) 732-3389

Other practice location 23

1400 Highway 71
International Falls, MN 56649-2154
Phone (218) 598-5665

Other practice location 24

614 Michigan Ave W
Walker, MN 56484-2276
Phone (218) 547-7700

Other practice location 25

111 2nd St NE
Fosston, MN 56542-1301
Phone (218) 435-1010

Other practice location 26

1656 Central St W Ste A
Bagley, MN 56621-4357
Phone (218) 694-2442

Other practice location 27

3220 Hannah Ave NW Ste 2
Bemidji, MN 56601
Phone (218) 209-3600

Other practice location 28

715 Delmore Dr
Roseau, MN 56751-1534
Phone (218) 463-2500

Other names

  • Joe Lueken Cancer Center Doing business as
  • Sanford Bagley Clinic Doing business as
  • Sanford Bagley Eye Center & Optical Doing business as
  • Sanford Bemidji 1611 Anne St Clinic Doing business as
  • Sanford Bemidji 1611 Eye Center & Optical Doing business as
  • Sanford Bemidji 1705 Ann St Clinic Doing business as
  • Sanford Bemidji 1705 Anne St Clinic Doing business as
  • Sanford Bemidji Behavioral Health Doing business as
  • Sanford Bemidji Blackduck Clinic Doing business as
  • Sanford Bemidji Cass Lake Clinic Doing business as
  • Sanford Bemidji Downtown Eye Center & Optical Doing business as
  • Sanford Bemidji Main Clinic Doing business as
  • Sanford Bemidji Main Clinic Outreach for Cook Doing business as
  • Sanford Bemidji Main Clinic Outreach to Neilson Place Doing business as
  • Sanford Bemidji Orthopedic and Sports Medicine Center Doing business as
  • Sanford Bemidji Sleep Center Doing business as
  • Sanford Health Baudette Eye Center & Optical Doing business as
  • Sanford Health Behavioral Health Administration Office Doing business as
  • Sanford Health Behavioral Health Headwaters ACT Doing business as
  • Sanford Health International Falls Eye Center & Optical Doing business as
  • Sanford Health Park Rapids Behavioral Health Center Doing business as
  • Sanford Health Park Rapids Clinic Doing business as
  • Sanford Health Thief River Falls Eye Center & Optical Doing business as
  • Sanford Health Walker Clinic Doing business as

Electronic endpoints

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

Other providers in Bemidji, MN

All providers in Bemidji, MN · Internal Medicine Physician in Minnesota

Sources for this page

Verify at the official NPI Registry.