Sanford Health of Northern Minnesota
Organization Active NPI Rural Acute Care Hospital · Bemidji, MN
NPI 1801870191 · NPPES record last updated Nov 27, 2023
Key facts
- NPI
- 1801870191
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Rural Acute Care Hospital 282NR1301X
- License
- 327482 (MN)
- Legal business name
- SANFORD HEALTH OF NORTHERN MINNESOTA
- Practice address
- 1300 Anne St NW
Bemidji, MN 56601-5103 - Phone
- (218) 751-5430
- NPI assigned
- Dec 1, 2005
- 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
Other NPIs on the same Medicare enrollment 1
Other NPIs with the same Medicare PAC ID 20
Corporate family (same tax ID) 22
Related certifications (CCN) 1
Facilities with the same owner 31
Practitioners 374
-
Wai Lun Chan, MD
-
Mark S Claussen, MD
-
Samuel David Cook, M.D.
-
Ekemini Hogan, MD
-
Michael Joannides, M.D.
-
Mohamed Manaa, MD
-
Emma Motl, MD
-
Matthew John Nielsen, M.D.
-
Johnna Nynas, M.D.
-
Aadil Amin Rajwani, MB BCH BAO
-
Ed Edil Rysal, DO
-
Ashok Sapkota, MD
-
Jolyn Seitz, M.D.
Affiliated clinicians 485
-
Paul C Allegra, MD
-
Randall Jay Ambroz, M.D.
-
Jonas Attilus, MD
-
Mohammed Azeemuddin, APRN, CNP
-
Prabhdeep Kaur Bajwa, M.D.
-
Emmalee Elaine Bardwell, O.D.
-
Ronald W. Bardwell, C.R.N.A.
-
Angela R Bentley, NP
-
Elizabeth Bernice Berg, M.D.
-
Sherry S Billups, DO
-
Amber Marie Biondich, APRN, CNP
-
Katlyn Bowman, PMHNP-BC
-
Patricia K Burdick, PA-C
Medicare Care Compare: Hospital
- Listed as
- Sanford Bemidji Medical Center
- Overall star rating
- ★★★★☆ 4 of 5
- Type
- Acute Care Hospitals
- Ownership
- Voluntary non-profit - Private
- Medicare certification status
- Active
- Emergency services
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
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 - Hospital subgroups
- Acute care
All disclosed owners & managing parties 24
| Name | Role | Since | Share |
|---|---|---|---|
| Mark Allen Lundeen |
Corporate Director |
Jan 1, 2014 | |
| Jason Joseph Caron |
W-2 Managing Employee |
Jan 1, 2026 | |
| Marnie Lynn Ventling-Herrmann |
Corporate Director |
Jan 1, 2022 | |
| Tony Lee Morrison |
W-2 Managing Employee |
Jan 19, 2020 | |
| Daniel George Hoody |
W-2 Managing Employee |
Oct 9, 2023 | |
| Brent Gerard Teiken |
Corporate Director |
Jul 3, 2012 | |
| Jolyn Joy Munson |
W-2 Managing Employee | Apr 17, 2025 | |
| Dana James Dykhouse |
Corporate Director |
Jan 1, 2024 | |
| Andrew Stewart North |
Corporate Director |
Jan 1, 2017 | |
| Renee Marie Axtman |
W-2 Managing Employee |
Jan 1, 2026 | |
| Stephanie Marie Herseth Sandlin |
Corporate Director |
Jan 1, 2024 | |
| William Joseph Gassen |
Corporate Director |
Nov 23, 2020 | |
| George Joseph Brown |
Corporate Director |
Jan 1, 2025 | |
| Wesley Owen Engbrecht |
Corporate Director |
Jan 1, 2021 | |
| Maureen Patricia McCausland |
Corporate Director |
Jan 1, 2025 | |
| Sanford |
5% Or Greater Indirect Ownership Interest | Mar 1, 2011 | 100% |
| Lisa Sue Miller |
W-2 Managing Employee | Sep 9, 2019 | |
| Thomas Richard Wenzel |
Corporate Director |
Jan 1, 2025 | |
| David Jonathan Shulkin |
Corporate Director |
Jan 1, 2024 | |
| Neil Leslie Gulsvig |
Corporate Director |
Mar 28, 2019 | |
| Kevin Victor Schieffer |
Corporate Director |
Jan 1, 2025 | |
| Lauris Nelson Molbert |
Corporate Director |
Jan 1, 2021 | |
| Nicholas Wayne Olson |
W-2 Managing Employee |
Apr 8, 2024 | |
| Sanford North |
5% Or Greater Direct Ownership Interest | Mar 1, 2011 | 100% |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20041026001020 | MN | Part a Provider - Hospital | 5597725168 |
2 other NPIs on this enrollment Practice locations: Walker, MN; Cass Lake, MN; Blackduck, MN; Bemidji, MN |
National Provider Directory
- Tax ID family
- North Country Health SE
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rural Acute Care Hospital | 282NR1301X | 327482 | MN | Yes |
Addresses
Primary practice location
1300 Anne St NW
Bemidji, MN 56601-5103
Mailing address
PO Box 5074
Sioux Falls, SD 57117-5074
Phone (053) 286-5856
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 314545001 | Medicaid | MN | |
| 314545000 | Medicaid | MN |
Other names
- Sanford Bemidji Medical Center
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service | Other |
Other providers in Bemidji, MN
- Sanford Health of Northern Minnesota
- Sanford Health of Northern Minnesota
- Sanford Health of Northern Minnesota
- Sanford Health of Northern Minnesota
- Sanford Health of Northern Minnesota
- Sanford Health of Northern Minnesota
- Sanford Healthcare Accessories, LLC
- Sanford Healthcare Accessories, LLC
- Sanford Medical Center Fargo
- Sanford Medical Center Fargo
All providers in Bemidji, MN · Rural Acute Care Hospital in Minnesota
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.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.