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SANFORD CLINIC NPI 1497787592


NPI Information

NPI: 1497787592
Provider Name: SANFORD CLINIC

Doing Business As: SANFORD CHILDREN'S CLINIC SANFORD USD MEDICAL CENTER MB2

Classification: Pediatrics - 208000000X
Entity Type: Organization

CLIA Number: 43D2145643

Address:
1205 S GRANGE AVE
STE 307
SIOUX FALLS, SD
ZIP 57105
Phone: (605) 328-7800
Get Directions

SANFORD CLINIC is a pediatrics in Sioux Falls, SD. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. SANFORD CLINIC NPI is 1497787592. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Sanford Children's Clinic Sanford Usd Medical Center Mb2.

The provider's business location address is:

1205 S GRANGE AVE
STE 307
SIOUX FALLS, SD
ZIP 57105-410
Phone: (605) 328-7800
Fax: (605) 328-7899

The provider's authorized official is Tony Lee Morrison .
The authorized official title is Vice President, Revenue Cycle and has the following contact phone number (605) 328-8380.

The CLIA number assigned to this NPI record is 43D2145643 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/7/2006 and was last updated on 11/27/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208000000XPediatricsYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
10562025MEDICAIDIOWA
2861458000MEDICAIDMINNESOTA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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