Sanford Clinic
Organization Active NPI Neuromusculoskeletal Medicine & OMM Physician · Sioux Falls, SD
NPI 1881600286 · NPPES record last updated Oct 8, 2015
Key facts
- NPI
- 1881600286
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Neuromusculoskeletal Medicine & OMM Physician 204D00000X
- Legal business name
- SANFORD CLINIC
- Practice address
- 1210 W 18TH St
Ste 100
Sioux Falls, SD 57104-9890 - Phone
- (605) 312-8500
- Fax
- (605) 312-8501
- NPI assigned
- Jul 31, 2006
- Organization subpart
- No
Authorized official
- Name
- Steve Goetsch
- Title
- Cfo
- Phone
- (605) 328-6940
Other NPIs on the same Medicare enrollment 37
Practitioners 19
-
Meghan Clemensen, CNP
-
Brianna Marie Davis, PA-C
-
Kara Jo Dejong, CNP
-
Keith A Hansen, M.D.
-
Caitlin Hanson, PA-C
-
Emily Hutchinson, CNP
-
Amit Jain, MD
-
Pierce Maslach, MD
-
Steven McGraw, MD
-
Elizabeth Miller, M.D.
-
Divyajot Singh Sandhu, M.D.
-
Angelo Noel Santos, M.D.
-
Sean D Kalagher, MD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (3 enrollments) in SD, MN, IA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031110000532 | SD | Part B Supplier - Clinic/Group Practice | 0244143824 |
Receives reassigned benefits from 941 practitioners This NPI is an additional NPI on the enrollment |
| O20040115000943 | MN | Part B Supplier - Clinic/Group Practice | 0244143824 |
Receives reassigned benefits from 113 practitioners 30 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Prior Lake, MN; Slayton, MN; Tracy, MN; Walker, MN; Windom, MN; Worthington, MN; Stillwater, MN; Luverne, MN… |
| O20040216001158 | IA | Part B Supplier - Clinic/Group Practice | 0244143824 |
Receives reassigned benefits from 66 practitioners 25 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Sheldon, IA; Sioux City, IA; Rock Rapids, IA; Orange City, IA; Inwood, IA; Hawarden, IA |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neuromusculoskeletal Medicine & OMM Physician |
204D00000X | Yes |
Addresses
Primary practice location
1210 W 18TH St
Ste 100
Sioux Falls, SD 57104-9890
Mailing address
PO Box 5074
Sioux Falls, SD 57117-5074
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0537886 | Medicaid | IA | |
| 281988100 | Medicaid | MN |
Other names
- Sanford Clinic Neurology
Other providers in Sioux Falls, SD
- 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 · Neuromusculoskeletal Medicine & OMM Physician in South Dakota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 8, 2015. 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.