SANFORD CLINIC NORTH NPI 1790710853

NPI Information

  • NPI: 1790710853
  • Provider Name: SANFORD CLINIC NORTH
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Organization
  • Doing Business As: SANFORD BEMIDJI CASS LAKE CLINIC
  • CLIA Number: 24D0406580
  • Address: 219 GRANT UTLEY AVENUE NW
    CASS LAKE, MN
    ZIP 56633
  • Phone: (218) 335-2559

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NPI Details

SANFORD CLINIC NORTH is a family medicine in Cass Lake, MN. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. SANFORD CLINIC NORTH NPI is 1790710853. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Sanford Bemidji Cass Lake Clinic.

The provider's business location address is:

219 GRANT UTLEY AVENUE NW
CASS LAKE, MN
ZIP 56633-067
Phone: (218) 335-2559
Fax: (218) 335-2755

The provider's authorized official is Martha K Leclerc .
The authorized official title is Vp and has the following contact phone number (701) 234-6248.

The CLIA number assigned to this NPI record is 24D0406580 - community clinic with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 7/11/2006 and was last updated on 11/2/2011.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily MedicineYes

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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1243816MEDICARE OSCAR/CERTIFICATIONMINNESOTA
2961888100MEDICAIDMINNESOTA

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: 11/21/2025

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