SANFORD DIALYSIS MORRIS Full NPI Record 1013077007
Clinic/Center - End-Stage Renal Disease (ESRD) Treatment in Morris, MN

Complete NPI Dataset

The following table represents the complete NPI 1013077007 dataset for Sanford Dialysis Morris in 400 E 1ST ST MORRIS, MN 56267. The data table includes a list of all field names, values and definitions of the complete NPI record. The NPI dataset is available for download in CSV format using the "Download NPI" button below at the end of the table.

Name Value Definition
NPI1013077007The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
Entity Type Code2Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Employer Identification Number EINUNAVAILThe Employer Identification Number (EIN), assigned by the IRS, of the provider being identified.
Provider Organization Name Legal Business NameSANFORD MEDICAL CENTER FARGOThe name of the organization provider. If the provider is an organization, this is the legal business name.
Provider Other Organization NameSANFORD DIALYSIS MORRISOther name by which the organization provider is or has been known.
Provider Other Organization Name Type Code3Code identifying the type of other name. Codes are: 1 = former name; 2 = professional name; 3 = doing business as (d/b/ a) name; 4 = former legal business name; 5 = other.
Provider First Line Business Mailing AddressPO BOX 2168The first line mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider first line location address’’.
Provider Business Mailing Address City NameFARGOThe city name in the mailing address of the provider being identified.
Provider Business Mailing Address State NameNDThe State or Province name in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address State name’’.
Provider Business Mailing Address Postal Code581072168The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as ‘‘Provider location address postal code’’.
Provider Business Mailing Address Country Code If outside U S USThe country code in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address country code’’.
Provider Business Mailing Address Telephone Number3205892832The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address telephone number’’.
Provider Business Mailing Address Fax Number3205899020The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address fax number’’.


Provider First Line Business Practice Location Address400 E 1ST STThe first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City NameMORRISThe city name in the location address of the provider being identified.
Provider Business Practice Location Address State NameMNThe State code in the location of the provider being identified.
Provider Business Practice Location Address Postal Code562671408The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Country Code If outside U S USThe country code in the location address of the provider being identified.
Provider Business Practice Location Address Telephone Number3205892832The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Fax Number7012342045The fax number associated with the location address of the provider being identified.
Provider Enumeration Date12/11/2006The date the provider was assigned a unique identifier (assigned an NPI).
Last Update Date6/25/2020The date that a record was last updated or changed.
Authorized Official Last NameMORRISONThe last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
Authorized Official First NameTONYThe first name of the authorized official.
Authorized Official Middle NameLEEThe middle name of the authorized official.
Authorized Official Title or PositionVICE PRESIDENT, REVENUE CYCLEThe title or position of the authorized official.
Authorized Official Telephone Number6053288380The 10-position telephone number of the authorized official.
Healthcare Provider Taxonomy Code 1261QE0700XCode designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
Healthcare Provider Primary Taxonomy Switch 1Y
Other Provider Identifier 14C29HMEAdditional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 101Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier Issuer 1MNBC
Other Provider Identifier 21018Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 205Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 2ND
Other Provider Identifier 3000026Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 301Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier Issuer 3NDBC
Other Provider Identifier 4360419500Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 405Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 4MN
Is Organization SubpartN
NPI Certification Date6/25/2020