NPIMap

Organization Active NPI

Sanford Health of Northern Minnesota

Doing business as Sanford Bemidji Medical Center

  • Rural Acute Care Hospital
  • Bemidji, MN
National Provider Identifier
1801870191
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Acute Care HospitalTaxonomy code 282NR1301X
License
327482 Issued in MN
Legal business name
SANFORD HEALTH OF NORTHERN MINNESOTA
Doing business as
Sanford Bemidji Medical Center
Practice address
1300 Anne St NW
Bemidji, MN 56601-5103
Phone
(218) 751-5430
NPI assigned
Dec 1, 2005
Last updated
Nov 27, 2023By the provider in NPPES
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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Acute Care Hospital 282NR1301X 327482 MN Primary

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 names 1

  • Sanford Bemidji Medical Center 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 MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041026001020 MN Part A Provider - Hospital 5597725168 2 other NPIs on this enrollment
Practice locations: Walker, MN; Cass Lake, MN; Blackduck, MN; Bemidji, MN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1801870191. Details of each certification follow.

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
CorporationNon-profit
Enrollment address
1300 Anne St NW
Bemidji, MN 56601-5103
Main/Primary Hospital Location
Hospital subgroups
Acute care

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

Other NPIs with the same Medicare PAC ID 20

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

View all 20

Other NPIs on the same Medicare enrollment 1

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Sanford Bemidji Medical CenterCCN 240100 · All quality measures
Overall star rating
4 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Tax ID family
Sanford Health of Minnesota23 organizations share this tax ID, including this one

Other organizations with this tax ID 22

Organizations that report the same tax identification number in the National Provider Directory.

View all 22

Locations

5201 Truxtun Ave
Bakersfield, CA 93309
Phone (661) 328-5565

Ownership & related parties

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

Owners & managing parties with NPI records 2

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

Facilities with the same owner 31

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 31

Practitioners & affiliated clinicians

Practitioners 57

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 57

Affiliated clinicians 484

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

View all 484

NPI Registry JSON

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

{
    "created_epoch": "1133395200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701043200000",
    "number": "1801870191",
    "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": "053-286-5856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 ANNE ST NW",
            "city": "BEMIDJI",
            "state": "MN",
            "postal_code": "566015103",
            "telephone_number": "218-751-5430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANFORD HEALTH OF NORTHERN MINNESOTA",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-01",
        "last_updated": "2023-11-27",
        "certification_date": "2020-07-07",
        "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": "282NR1301X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Rural",
            "state": "MN",
            "license": "327482",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Bemidji Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bemidji, MN

Sources for this page

Verify at the official NPI Registry.