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SANFORD HEALTH MAHNOMEN CLINIC
NPI 1831131234
Clinic/Center - Rural Health in Mahnomen, MN

Active since June 11, 2006CLIA 24D0726258 · Waiver
410 4TH ST NW, MAHNOMEN, MN 56557(218) 935-2514(218) 935-2720 Get Directions Write a Review

NPPES record last updated: November 29, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Nov 29, 2022, Jul 7, 2020, Feb 20, 2020 and 1 more (4 updates tracked since 2019).

About Sanford Health Mahnomen Clinic NPPES

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

SANFORD HEALTH MAHNOMEN CLINIC (NPI 1831131234) is a healthcare organization registered as a rural health in Mahnomen, Minnesota and active in the NPI registry since June 2006. The organization holds a CLIA Waiver certificate valid through August 31, 2026 and lists Tony Lee Morrison, Vice President, Revenue Cycle, as its authorized official.

NPPES Registry Identity

NPI1831131234
Entity TypeOrganization
Primary Taxonomy261QR1300X
Legal Business NameSANFORD MEDICAL CENTER FARGO
Location Address410 4TH ST NWMahnomen, MN 56557-4208
Mailing AddressPo Box 2168Fargo, ND 58107-2168 · (701) 234-2119
Phone(218) 935-2514
Fax(218) 935-2720
Organization SubpartNo
Authorized OfficialTony Lee MorrisonVice President, Revenue Cycle · (605) 328-8380
Enumeration DateJune 11, 2006
Last NPPES UpdateNovember 29, 20224 updates tracked since enumeration
NPPES CertifiedNovember 29, 2022
✔ NPI 1831131234 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyClinic/Center · Rural HealthAmbulatory Health Care Facilities
Taxonomy Code261QR1300X
Also ListedFamily MedicineTaxonomy 207Q00000X
Also ListedInternal MedicineTaxonomy 207R00000X
Also ListedObstetrics & GynecologyTaxonomy 207V00000X
410 4TH ST NW, Mahnomen, MN 56557
Open in Google Maps ↗

Other Names 1

Doing Business AsSanford Health Mahnomen Clinic

Other Identifiers 1

Medicaid954222100MN

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

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include HealthPartners, Medica, Sanford Health Plan and more.Insurance ›

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 24D0726258

Sanford Health Mahnomen Clinic · Mahnomen, MN
Active · expires Aug 31, 2026
CLIA Number24D0726258
Laboratory TypeCommunity Clinic
Certificate Effective DateSeptember 1, 2024
Certificate Expiration DateAugust 31, 2026
Laboratory DirectorKaitlin Moser
Laboratory Phone(218) 935-2514
Laboratory LocationSanford Health Mahnomen Clinic410 West 4th Street, Mahnomen, MN 56557
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 4

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

KRISTEN HEMMINGSEN NP
Nurse Practitioner (Family)
410 4TH ST NW
MAHNOMEN, MN 56557
Mahnomen County (218) 935-2514
KAGEN ARTHUR WAAGE
Physician Assistant (Medical)
410 4TH ST NW
MAHNOMEN, MN 56557
Mahnomen County (218) 935-2514
GRETCHEN BEA ROCKSTAD LRD
Dietitian, Registered
410 4TH ST NW
MAHNOMEN, MN 56557
Mahnomen County (218) 835-2514
MACEY SCHAEFBAUER PA-C
Physician Assistant
410 4TH ST NW
MAHNOMEN, MN 56557
Mahnomen County (218) 935-2514

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 Medical Center Fargo's NPI number?

The NPI number for Sanford Medical Center Fargo is 1831131234. It was assigned to this organization in the NPPES registry on June 11, 2006. The provider is doing business as Sanford Health Mahnomen Clinic.

Where is Sanford Medical Center Fargo located?

Sanford Medical Center Fargo is located at 410 4th St NW, Mahnomen, MN 56557. The listed phone number is (218) 935-2514.

What is Sanford Medical Center Fargo's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Rural Health, with taxonomy code 261QR1300X.

Does Sanford Medical Center Fargo hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 24D0726258) is associated with this NPI, valid through August 31, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Sanford Medical Center Fargo accept?

Health plans from HealthPartners, Medica, Sanford Health Plan and Security Health Plan list Sanford Medical Center Fargo as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Sanford Medical Center Fargo was last updated on November 29, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.