SANFORD BROADWAY MEDICAL BUILDING
NPI 1609156900
Internal Medicine - Infectious Disease in Fargo, ND

NPI Status: Active since August 18, 2011

Contact Information

736 BROADWAY N
FARGO, ND
ZIP 58102
Phone: (701) 234-2000

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  • Organization
  • Internal Medicine
  • Infectious Disease
  • CLIA Number: 35D0655616
  • CLIA Cert. Type: Independent
  • CLIA Exp. Date: 02-08-2027

About SANFORD BROADWAY MEDICAL BUILDING

This page provides the complete NPI Profile along with additional information for Sanford Broadway Medical Building, an internist established in Fargo, North Dakota operating as a Internal Medicine, focusing in infectious disease . The healthcare provider is registered in the NPI registry with number 1609156900 assigned on August 2011. The practitioner's primary taxonomy code is 207RI0200X. The provider is registered as an organization and their NPI record was last updated 2 years ago. Sanford Broadway Medical Building operates as a multi-specialty business group with one or more individual providers who practice different areas of specialization. The provider's is doing business as Sanford Broadway Medical Building. The authorized official of this NPI record is Martha Leclerc (Vice President)

NPI
1609156900
Provider Legal Name
SANFORD MEDICAL CENTER FARGO
Other Organization Name
SANFORD BROADWAY MEDICAL BUILDING
Other Name Type
Doing Business As (3)
Entity Type
Organization
Location Address
736 BROADWAY N FARGO, ND 58102
Location Phone
(701) 234-2000
Mailing Address
736 BROADWAY N FARGO, ND 58102
Mailing Phone
(701) 234-2000
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
08-18-2011
Last Update Date
11-27-2023
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An internist like Sanford Broadway Medical Building is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Internal Medicine Infectious Disease

Taxonomy Code
207RI0200X
Type
Allopathic & Osteopathic Physicians
Taxonomy Description
An internist who deals with infectious diseases of all types and in all organ systems. Conditions requiring selective use of antibiotics call for this special skill. This physician often diagnoses and treats AIDS patients and patients with fevers which have not been explained. Infectious disease specialists may also have expertise in preventive medicine and travel medicine.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1111N00000XChiropractic Providers

Chiropractor

 
2133V00000XDietary & Nutritional Service Providers

Dietitian, Registered

 
3208100000XAllopathic & Osteopathic Physicians

Physical Medicine & Rehabilitation

 

Group Taxonomy 193200000X MULTI-SPECIALTY GROUP

This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

MARTHA LECLERC

Authorized Official Title
VICE PRESIDENT
Authorized Official Phone
(701) 234-6248

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
35D0655616
Facility Type
Independent
Certificate Effective Date
February 09, 2025
Certificate Expiration Date
February 08, 2027
Laboratory Director
DR. JODY R. THOMPSON
Certificate Type
Certificate of Accreditation
Certificate Type Description
This is a CLIA certificate is issued to Sanford Broadway Medical Building on the basis of the laboratory's accreditation by an accreditation organization approved by CMS. This type of certificate is issued to a laboratories tha perform nonwaived (moderate and/or high complexity) testing.

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1609156900
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2609251290
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 6 + 0 + 9 + 2 + 5 + 1 + 2 + 9 + 0 + 24 = 60
Step 3: because the number obtained in step 2 ends in zero, the check digit is zero.
0

The NPI number 1609156900 is valid because the calculated check digit 0 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 20 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1871996298 LINDA THORSETH PT
Individual
Physical Therapist736 BROADWAY N RT #1031 SANFORD HEALTH BROADWAY MEDICAL PT DEPT
FARGO, ND 58102
(701) 234-6531
1669875092MR. JAMES HENRY CLAPP DPT
Individual
Physical Therapist (Orthopedic)736 BROADWAY N
FARGO, ND 58102
(701) 234-6735
1942603279MR. BRIAN ALAN SKJERSETH PT
Individual
Physical Therapist (Orthopedic)736 BROADWAY N
FARGO, ND 58102
(701) 234-6735
1083017370MRS. JENNIFER LYNN LAMP P.T.
Individual
Physical Therapist (Orthopedic)736 BROADWAY N
FARGO, ND 58102
(701) 234-6735
1780087015 GREG GRENZ PT
Individual
Physical Therapist (Orthopedic)736 BROADWAY N
FARGO, ND 58102
(701) 234-6735
1255734414 ALEXA RISAN DPT
Individual
Physical Therapist736 BROADWAY N
FARGO, ND 58102
(701) 234-6735
1801290119 KRISTIN GUDERIAN D.P.T.
Individual
Physical Therapist736 BROADWAY N
FARGO, ND 58102
(701) 234-6735
1871607945 TIMOTHY S. BISCHOF MD
Individual
Internal Medicine (Infectious Disease)736 BROADWAY N
FARGO, ND 58102
(701) 234-2353
1972965903 CODY FREUDENTHAL CRNA
Individual
Nurse Anesthetist, Certified Registered736 BROADWAY N
FARGO, ND 58102
(701) 234-2000
1831647668 EVAN MARTELL DPT
Individual
Physical Therapist736 BROADWAY N
FARGO, ND 58102
(701) 234-2000
1528501418 ANITA AARESTAD RD, LRD, CSR
Individual
Dietitian, Registered (Nutrition, Renal)736 BROADWAY N
FARGO, ND 58102
(701) 234-2000
1689941999 IVY L JORDAN DPT
Individual
Physical Therapist736 BROADWAY N
FARGO, ND 58102
(701) 234-2000
1427618800 ALISON LYNN KOPP PT
Individual
Physical Therapist736 BROADWAY N
FARGO, ND 58102
(701) 234-6528
1730270901 NICOLE M ROSTAD HOLDMAN LRD
Individual
Dietitian, Registered736 BROADWAY N
FARGO, ND 58102
(701) 234-4111
1528666914MS. BRETT BROCKPAHLER PT, DPT
Individual
Physical Therapist736 BROADWAY N
FARGO, ND 58102
(701) 234-6735
1073091757MR. MITCHELL JULIUS LIKNESS PA-C
Individual
Physician Assistant736 BROADWAY N
FARGO, ND 58102
(605) 280-0669
1184642738 NICOLE M WELSCH LRD
Individual
Dietitian, Registered736 BROADWAY N
FARGO, ND 58102
(701) 234-2000
1285081323DR. MOLLY ANN BERG DNP, FNP
Individual
Nurse Practitioner736 BROADWAY N
FARGO, ND 58102
(701) 234-2000
1356735724 PATRICIA RAU RD, LD
Individual
Dietitian, Registered736 BROADWAY N
FARGO, ND 58102
(701) 234-2000
1548633951 BRANDON SZKLARSKI DPT
Individual
Physical Therapist736 BROADWAY N
FARGO, ND 58102
(701) 234-2000

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1609156900, enumerated in the NPI registry as an "organization" on August 18, 2011

The provider is located at 736 Broadway N Fargo, Nd 58102 and the phone number is (701) 234-2000

This medical organization specializes in Internal Medicine with taxonomy code 207RI0200X with a focus in Infectious Disease

The provider's CLIA number is 35D0655616 for a "independent" facility with a CLIA Certificate of Accreditation. This is a CLIA certificate is issued on the basis of the laboratory's accreditation by an accreditation organization approved by CMS. This type of certificate is issued to a laboratories tha perform nonwaived (moderate and/or high complexity) testing..

This NPI record was last updated on August 18, 2011. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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