NPI 1154587780 · live from the CMS NPI Registry
Sanford Health Of Northern Minnesota
Ophthalmology in Bemidji, MN. National Provider Identifier 1154587780, active.
NPI record
| NPI | 1154587780 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Ophthalmology 207W00000X |
| Practice location | 1611 Anne St Nw, Ste 7, Bemidji, MN 56601 |
| Practice phone | 218-333-2020 |
| Mailing address | Po Box 5074, Sioux Falls, SD 57117 |
| Enumerated | August 4, 2008 |
| Last updated | January 23, 2025 |
| Authorized official | Tony Morrison, Vice President, Revenue Cycle |
| Other names | Sanford Health 1611 Eye Center & Optical |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Optometrist | 152W00000X | — |
| Dermatology | 207N00000X | — |
| Ophthalmology primary | 207W00000X | — |
| Eyewear Supplier (Equipment, not the service) | 332H00000X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.