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SANFORD BEMIDJI 1611 ANNE ST. CLINIC
NPI 1083994388
Family Medicine in Bemidji, MN

Active since August 18, 2011CLIA 24D2002500 · Accreditation
1611 ANNE ST NW, BEMIDJI, MN 56601(218) 333-2020(218) 333-2019 Get Directions Write a Review

NPPES record last updated: November 27, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Sanford Bemidji 1611 Anne St. Clinic NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SANFORD BEMIDJI 1611 ANNE ST. CLINIC (NPI 1083994388) is a healthcare organization registered as a family medicine in Bemidji, Minnesota and active in the NPI registry since August 2011. The organization holds an CLIA Accreditation certificate valid through September 30, 2026 and lists Martha K Leclerc, Vp, as its authorized official.

NPPES Registry Identity

NPI1083994388
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameSANFORD CLINIC NORTH
Location Address1611 ANNE ST NWBemidji, MN 56601-5114
Mailing Address1611 Anne St NwBemidji, MN 56601-5114 · (218) 333-2020 · Fax (218) 333-2019
Phone(218) 333-2020
Fax(218) 333-2019
Organization SubpartNo
Authorized OfficialMartha K LeclercVp · (701) 234-6248
Enumeration DateAugust 18, 2011
Last NPPES UpdateNovember 27, 2023
✔ NPI 1083994388 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
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.
Also ListedAnesthesiologyTaxonomy 207L00000X
Also ListedPediatricsTaxonomy 208000000X
Also ListedPodiatristTaxonomy 213E00000X
1611 ANNE ST NW, Bemidji, MN 56601
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Other Names 1

Doing Business AsSanford Bemidji 1611 Anne St. Clinic

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Accreditation 24D2002500

Sanford Bemidji Clinic 1611 North · Bemidji, MN
Active · expires Sep 30, 2026
CLIA Number24D2002500
Laboratory TypePbb Clinic
Certificate Effective DateOctober 1, 2024
Certificate Expiration DateSeptember 30, 2026
Laboratory DirectorMarcy Hanson
Laboratory Phone(218) 333-2596
Laboratory LocationSanford Bemidji Clinic 1611 North1611 Anne Street NW, Bemidji, MN 56601
CLIA data matches this NPI record on: Address
This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

STEPHEN J VANDYKE OD
Optometrist
1611 ANNE ST NW
BEMIDJI, MN 56601
Beltrami County (218) 333-2020
JILL OLSON MD
Family Medicine
1611 ANNE ST NW
BEMIDJI, MN 56601
Beltrami County (218) 333-5000
WILLIAM G DICKS MD
Family Medicine
1611 ANNE ST NW
BEMIDJI, MN 56601
Beltrami County (218) 333-5111
GERMAINE E CHESLOCK O.D.
Optometrist
1611 ANNE ST NW
BEMIDJI, MN 56601
Beltrami County (218) 333-2020
SANFORD HEALTH OF NORTHERN MINNESOTA
Ophthalmology
1611 ANNE ST NW, STE 7
BEMIDJI, MN 56601
Beltrami County (218) 333-2020
EDGAR LEE ESPE DPM
Podiatrist
1611 ANNE ST NW
BEMIDJI, MN 56601
Beltrami County (218) 333-4915
SHELBY MARIE POTKIN MD
Ophthalmology
1611 ANNE ST NW
BEMIDJI, MN 56601
Beltrami County (218) 333-2020
SERENA JO MADDEN MSN, APRN, FNP-C
Nurse Practitioner (Family)
1611 ANNE ST NW
BEMIDJI, MN 56601
Beltrami County (218) 333-5000

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Sanford Clinic North's NPI number?

The NPI number for Sanford Clinic North is 1083994388. It was assigned to this organization in the NPPES registry on August 18, 2011. The provider is doing business as Sanford Bemidji 1611 Anne St. Clinic.

Where is Sanford Clinic North located?

Sanford Clinic North is located at 1611 Anne St NW, Bemidji, MN 56601. The listed phone number is (218) 333-2020.

What is Sanford Clinic North's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Does Sanford Clinic North hold a CLIA laboratory certificate?

Yes. A Certificate of Accreditation (number 24D2002500) is associated with this NPI, valid through September 30, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Sanford Clinic North was last updated on November 27, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.