Sanford Clinic

Primary specialty

Sports Medicine (Internal Medicine) PhysicianTaxonomy code 207RS0010X

Legal business name

SANFORD CLINIC

Practice address

1210 W 18TH St
Suite G01
Sioux Falls, SD 57104-4647

Phone

(605) 328-1750

Fax

(605) 328-1751

NPI assigned

Jul 31, 2006

Organization subpart

No

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

Authorized official

Name

Steve Geotsch

Title

Cfo

Phone

(605) 328-4538

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Sanford Clinic Sports Medicine Doing business as

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in SD

Enrollment records 1

Locations

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701043200000",
    "number": "1790791101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1210 W 18TH ST",
            "address_2": "SUITE G01",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571044647",
            "telephone_number": "605-328-1750",
            "fax_number": "605-328-1751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1210 W 18TH ST",
            "address_2": "SUITE G01",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571044647",
            "telephone_number": "605-328-1750",
            "fax_number": "605-328-1751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANFORD CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-31",
        "last_updated": "2023-11-27",
        "status": "A",
        "authorized_official_last_name": "GEOTSCH",
        "authorized_official_first_name": "STEVE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "605-328-4538"
    },
    "taxonomies": [
        {
            "code": "207RS0010X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Sports Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "684424300",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0562025",
            "state": "IA"
        }
    ],
    "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 Clinic Sports Medicine",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Sanford Clinic Sports Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sanford Clinic
• Sanford Clinic
• Sanford Clinic
• Sanford Clinic
• Sanford Clinic
• Sanford Clinic
• Sanford Clinic
• Sanford Clinic
• Sanford Clinic
• Sanford Clinic

• All providers in Sioux Falls, SD
• Sports Medicine (Internal Medicine) Physician in South Dakota

• 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.