Specialization : | Pediatrics |
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Provider Name : | Sanford Clinic North |
Other Name : | Sanford Health Wahpeton Clinic |
Primary Address : | 801 Broadway N Fargo, ND, 58102-3641 United States |
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Phone Number : | 701-234-2000 |
NPI Number : | 1942241351 |
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NPI Entity Type : | Organization |
First Enrolment Date : | 09 Jun, 2006 |
Last Updated On : | 29 Nov, 2022 |
Authorized Official Name : | Tonylee Morrison |
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Official Title or Position : | Vice President |
Phone Number : | 6053288380 |
Taxonomy Code | Speciality | Primary | License No. | State |
---|---|---|---|---|
204E00000X | Oral & Maxillofacial Surgery | No | - | |
204F00000X | Transplant Surgery | No | - | |
207K00000X | Allergy & Immunology | No | - | |
207L00000X | Anesthesiology | No | - | |
207R00000X | Internal Medicine | No | - | |
207V00000X | Obstetrics & Gynecology | No | - | |
207Y00000X | Otolaryngology | No | - | |
207ZP0101X | Pathology, Anatomic Pathology | No | - | |
208100000X | Physical Medicine & Rehabilitation | No | - | |
2085R0202X | Radiology, Diagnostic Radiology | No | - | |
208600000X | Surgery | No | - | |
208800000X | Urology | No | - | |
208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) | No | - | |
291U00000X | Clinical Medical Laboratory | No | - | |
208000000X | Pediatrics | Yes | - |
Identifier | Identifier Type | State | Issuer |
---|---|---|---|
192972600 | Other (non-Medicare) | ND | FEDERAL WORKERS COMP |
192974000 | Other (non-Medicare) | ND | FEDERAL WORKERS COMP(MC) |
C02382 | MEDICARE PIN | MN | |
CD8868 | Other (non-Medicare) | MN | RR MEDICARE |
CD8868 | MEDICARE PIN | ||
CD8870 | Other (non-Medicare) | ND | RR MEDICARE |
CD8870 | MEDICARE PIN | ||
N22952 | MEDICARE PIN | ND | |
N6206 | MEDICARE PIN | ND | |
N70164 | MEDICARE PIN | ND | |
N70204 | MEDICARE PIN | ND | |
N70332 | MEDICARE PIN | ND | |
N70334 | MEDICARE PIN | ND | |
N70339 | MEDICARE PIN | ND | |
N70359 | MEDICARE PIN | ND | |
N70401 | MEDICARE PIN | ND | |
N70636 | MEDICARE PIN | ND | |
N70751 | MEDICARE PIN | ND | |
N70846 | MEDICARE PIN | ND | |
N70848 | MEDICARE PIN | ND | |
N70918 | MEDICARE PIN | ND | |
N71069 | MEDICARE PIN | ND | |
N71155 | MEDICARE PIN | ND | |
N71157 | MEDICARE PIN | ND |
Practice Address | City, State | Phone Number |
---|---|---|
520 CHAUTAUQUA BLVD, VALLEY CITY, ND, 58072-3145 United States | VALLEY CITY, ND | 701-845-6000 |
4820 23RD AVE S STE 100, FARGO, ND, 58104-9137 United States | FARGO, ND | 701-417-7300 |
1750 47TH AVE S, GRAND FORKS, ND, 58201 United States | GRAND FORKS, ND | 701-757-8700 |
1234 WASHINGTON AVE STE A, DETROIT LAKES, MN, 56501-3906 United States | DETROIT LAKES, MN | 218-846-2000 |
2800 S COLUMBIA RD STE 112, GRAND FORKS, ND, 58201-6030 United States | GRAND FORKS, ND | 701-757-8900 |
618 14TH AVE NE, DEVILS LAKE, ND, 58301-2808 United States | DEVILS LAKE, ND | 701-544-7000 |
206 PLEASANT AVE S, PARK RAPIDS, MN, 56470-1417 United States | PARK RAPIDS, MN | 218-732-3389 |
2400 ST FRANCIS DR, BRECKENRIDGE, MN, 56520-1025 United States | BRECKENRIDGE, MN | 701-642-7000 |
501 2ND ST NW, TWIN VALLEY, ND, 56584-0996 United States | TWIN VALLEY, ND | 218-584-5142 |
Endpoint Type | Endpoint | Affiliation | Use | Content | Address |
---|---|---|---|---|---|
CONNECT (CONNECT URL) | https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service 2.16.840.1.113883.3.1068.1 | OTHER Other CMS esMD eMDR | 2720 Dundee Rd # 302, Northbrook, IL, 60062-2609 United States |
Mailing Address : | Po Box 5074 Sioux Falls, SD, 57117-5074 United States |
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Phone Number : | 605-328-6585 |