SANFORD MOORHEAD CLINIC
NPI 1609156934
Internal Medicine in Moorhead, MN

NPI Status: Active since August 18, 2011

Contact Information

1301 8TH ST S
MOORHEAD, MN
ZIP 56560
Phone: (701) 234-3200

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  • Organization
  • Internal Medicine
  • CLIA Number: 24D0041369
  • CLIA Cert. Type: Community Clinic
  • CLIA Exp. Date: 03-30-2026

About SANFORD MOORHEAD CLINIC

This page provides the complete NPI Profile along with additional information for Sanford Moorhead Clinic, an internist established in Moorhead, Minnesota operating as a Internal Medicine. The healthcare provider is registered in the NPI registry with number 1609156934 assigned on August 2011. The practitioner's primary taxonomy code is 207R00000X. The provider is registered as an organization and their NPI record was last updated 2 years ago. Sanford Moorhead Clinic 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 Moorhead Clinic. The authorized official of this NPI record is Martha Leclerc (Vice President)

NPI
1609156934
Provider Legal Name
SANFORD MEDICAL CENTER FARGO
Other Organization Name
SANFORD MOORHEAD CLINIC
Other Name Type
Doing Business As (3)
Entity Type
Organization
Location Address
1301 8TH ST S MOORHEAD, MN 56560
Location Phone
(701) 234-3200
Mailing Address
1301 8TH ST S MOORHEAD, MN 56560
Mailing Phone
(701) 234-3200
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 Moorhead Clinic 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

Taxonomy Code
207R00000X
Type
Allopathic & Osteopathic Physicians
Taxonomy Description
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

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)
1207Q00000XAllopathic & Osteopathic Physicians

Family Medicine

 

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
24D0041369
Facility Type
Community Clinic
Certificate Effective Date
March 31, 2024
Certificate Expiration Date
March 30, 2026
Laboratory Director
DR. TOSHI GHOSH
Certificate Type
Certificate of Accreditation
Certificate Type Description
This is a CLIA certificate is issued to Sanford Moorhead Clinic 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.

Reviews for SANFORD MOORHEAD CLINIC

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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.
1609156934
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2609251296
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 + 6 + 24 = 66
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
70 - 66 = 44

The NPI number 1609156934 is valid because the calculated check digit 4 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 16 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1174556591SANFORD CLINIC NORTH
Organization
Internal Medicine1301 8TH ST S
MOORHEAD, MN 56560
(701) 234-3200
1013935758 ROBERT D CAMPBELL MD
Individual
Family Medicine1301 8TH ST S
MOORHEAD, MN 56560
(701) 234-3260
1689692220 STEVEN K GLUNBERG MD
Individual
Family Medicine1301 8TH ST S
MOORHEAD, MN 56560
(701) 234-3260
1184646671 ROSE MARY ELDRIDGE NP
Individual
Nurse Practitioner1301 8TH ST S
MOORHEAD, MN 56560
(701) 234-3200
1285005991 BRIANNA J CRAWFORD PHD
Individual
Psychologist1301 8TH ST S
MOORHEAD, MN 56560
(701) 234-3100
1437662640DR. CAITLIN POLLESTAD PH.D, LP
Individual
Psychologist1301 8TH ST S
MOORHEAD, MN 56560
(701) 234-3100
1336508274 AMANDA STOREY PSYD
Individual
Psychologist1301 8TH ST S
MOORHEAD, MN 56560
(701) 234-3100
1376925958 YU-TING WUNG MD
Individual
Psychiatry & Neurology (Psychiatry)1301 8TH ST S
MOORHEAD, MN 56560
(701) 234-3100
1588044432 ALICIA LYNN ELLIOTT D.O.
Individual
Psychiatry & Neurology (Psychiatry)1301 8TH ST S
MOORHEAD, MN 56560
(701) 234-3100
1154343705 MICHAEL L SAND DO
Individual
Internal Medicine1301 8TH ST S
MOORHEAD, MN 56560
(701) 234-3200
1871565929 MARY L RYMANOWSKI LICSW
Individual
Social Worker (Clinical)1301 8TH ST S
MOORHEAD, MN 56560
(701) 234-3100
1023370061DR. TIFFANY ANN DOYLE M.D.
Individual
Psychiatry & Neurology (Psychiatry)1301 8TH ST S
MOORHEAD, MN 56560
(701) 234-3100
1144323700 CAROLE YVONNE HALONE LICSW
Individual
Social Worker (Clinical)1301 8TH ST S
MOORHEAD, MN 56560
(701) 234-3100
1184204539 EBONEE M RONNINGEN MSW, LCSW, LICSW
Individual
Social Worker (Clinical)1301 8TH ST S
MOORHEAD, MN 56560
(701) 234-3100
1326655689MR. SAMIR GOLOS
Individual
Nurse Practitioner (Psychiatric/Mental Health)1301 8TH ST S
MOORHEAD, MN 56560
(701) 234-3100
1942599048DR. JONATHAN CHARLES OLIVAS MD
Individual
Psychiatry & Neurology (Psychiatry)1301 8TH ST S
MOORHEAD, MN 56560
(701) 234-3100

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1609156934, enumerated in the NPI registry as an "organization" on August 18, 2011

The provider is located at 1301 8th St S Moorhead, Mn 56560 and the phone number is (701) 234-3200

This medical organization specializes in Internal Medicine with taxonomy code 207R00000X

The provider's CLIA number is 24D0041369 for a "community clinic" 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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