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PERHAM HEALTH OTTERTAIL CLINIC
NPI 1619900289
Family Medicine in Ottertail, MN

Active since July 08, 2006
105 OTTER DRIVE, OTTERTAIL, MN 56571(218) 367-6111(218) 367-6110 Get Directions Write a Review

NPPES record last updated: November 7, 2011. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Perham Health Ottertail Clinic NPPES

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

PERHAM HEALTH OTTERTAIL CLINIC (NPI 1619900289) is a healthcare organization registered as a family medicine in Ottertail, Minnesota and active in the NPI registry since July 2006. The organization lists Martha K Leclerc, Vp, as its authorized official.

NPPES Registry Identity

NPI1619900289
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameSANFORD CLINIC NORTH
Location Address105 OTTER DRIVEOttertail, MN 56571-7040
Mailing Address720 4th St N, Po Box 2010Fargo, ND 58122-0605 · (218) 367-6111 · Fax (218) 367-6110
Phone(218) 367-6111
Fax(218) 367-6110
Organization SubpartNo
Authorized OfficialMartha K LeclercVp · (701) 234-6248
Enumeration DateJuly 8, 2006
Last NPPES UpdateNovember 7, 2011
✔ NPI 1619900289 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ 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.
105 OTTER DRIVE, Ottertail, MN 56571
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Other Names 1

Doing Business AsPerham Health Ottertail Clinic

Other Identifiers 2

Medicare OSCAR/certification243867MN
Medicaid44100700MN

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE 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 Waiver 24D1042442

Perham Health Ottertail Clinic · Ottertail, MN
Expired · Jul 31, 2026
CLIA Number24D1042442
Laboratory TypeRural Health Clinic
Certificate Effective DateAugust 1, 2024
Certificate Expiration DateJuly 31, 2026
Laboratory DirectorJerry J. Baldwin
Laboratory Phone(218) 367-6111
Laboratory LocationPerham Health Ottertail ClinicAttn Laboratory 105 Otter Drive, Ottertail, MN 56571
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

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

DAVID A BACHELDER PA-C
Physician Assistant (Medical)
105 OTTER DRIVE
OTTERTAIL, MN 56571
Otter Tail County (218) 367-6111

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 1619900289. It was assigned to this organization in the NPPES registry on July 8, 2006. The provider is doing business as Perham Health Ottertail Clinic.

Where is Sanford Clinic North located?

Sanford Clinic North is located at 105 Otter Drive, Ottertail, MN 56571. The listed phone number is (218) 367-6111.

What is Sanford Clinic North's specialty?

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

When was this NPI record last updated?

The NPPES record for Sanford Clinic North was last updated on November 7, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.