| Sanford Health Network | |
|
215 N Market St Suite 2 Lake Park IA 51347-7706 | |
| (712) 832-9559 | |
| (877) 368-6054 |
| Full Name | Sanford Health Network |
|---|---|
| Speciality | Clinic/Center |
| Location | 215 N Market St, Lake Park, Iowa |
| Authorized Official Name and Position | Tony Lee Morrison (VICE PRESIDENT, REVENUE CYCLE) |
| Authorized Official Contact | 6053288380 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sanford Health Network Po Box 5074 Sioux Falls SD 57117-5074 Ph: (605) 312-8854 | Sanford Health Network 215 N Market St Suite 2 Lake Park IA 51347-7706 Ph: (712) 832-9559 |
| NPI Number | 1134787930 |
|---|---|
| Provider Enumeration Date | 06/05/2019 |
| Last Update Date | 01/23/2025 |
| Medicare PECOS PAC ID | 6800707100 |
|---|---|
| Medicare Enrollment ID | O20040324000654 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134787930 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| Provider Name | Ann M Berens |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1346241478 PECOS PAC ID: 5193624914 Enrollment ID: I20031231000199 |
| Provider Name | Craig P Mckay |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1164528055 PECOS PAC ID: 8527098433 Enrollment ID: I20051014000025 |
| Provider Name | Amy M Badberg |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1588746515 PECOS PAC ID: 4183723588 Enrollment ID: I20070626000603 |
| Provider Name | Scott A Lichty |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124129127 PECOS PAC ID: 9234239369 Enrollment ID: I20070703000095 |
| Provider Name | Sara Zoelle |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1417039447 PECOS PAC ID: 4587764618 Enrollment ID: I20070703000106 |
| Provider Name | Brian D Lindaman |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1912121229 PECOS PAC ID: 4183718315 Enrollment ID: I20070919000650 |
| Provider Name | Beta J Hamon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1376553040 PECOS PAC ID: 8224026349 Enrollment ID: I20071219000004 |
| Provider Name | Jacqueline D Kramer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356307466 PECOS PAC ID: 7012079197 Enrollment ID: I20081224000268 |
| Provider Name | Sally Jo Mcmahon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073787255 PECOS PAC ID: 2365506243 Enrollment ID: I20090122000296 |
| Provider Name | Rita Hogue |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1285878777 PECOS PAC ID: 3678623295 Enrollment ID: I20090602000532 |
| Provider Name | Kim N Hurtig |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1972692663 PECOS PAC ID: 4284786682 Enrollment ID: I20090716000023 |
| Provider Name | Ronald M Haan |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1861425753 PECOS PAC ID: 9537183165 Enrollment ID: I20090717000134 |
| Provider Name | Paul D Beninga |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1760415640 PECOS PAC ID: 4880769751 Enrollment ID: I20090717000150 |
| Provider Name | Mark R Dahlquist |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1225044118 PECOS PAC ID: 3072529460 Enrollment ID: I20090721000587 |
| Provider Name | Michelle L Johnson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912107426 PECOS PAC ID: 3678628740 Enrollment ID: I20090923000676 |
| Provider Name | Myles E Tieszen |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1063464683 PECOS PAC ID: 3678473949 Enrollment ID: I20100212000165 |
| Provider Name | Jason A Chester |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1356425805 PECOS PAC ID: 3072640846 Enrollment ID: I20100427000722 |
| Provider Name | William R Jongewaard |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1336128453 PECOS PAC ID: 2365571221 Enrollment ID: I20100602000607 |
| Provider Name | James M Donohue |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1598729550 PECOS PAC ID: 0244133882 Enrollment ID: I20100817001618 |
| Provider Name | Donna L Rosenboom |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1780756833 PECOS PAC ID: 3779731955 Enrollment ID: I20120912000813 |
| Provider Name | Christopher A Otto |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1083671705 PECOS PAC ID: 7517115744 Enrollment ID: I20120913000430 |
| Provider Name | Kirk J Sneiderman |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1881967925 PECOS PAC ID: 9931357035 Enrollment ID: I20120914000320 |
| Provider Name | Teresa N Sampson |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1306918479 PECOS PAC ID: 4385895101 Enrollment ID: I20121102000505 |
| Provider Name | Cathy S Hennies |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1396749768 PECOS PAC ID: 0648291955 Enrollment ID: I20130208000443 |
| Provider Name | Ryan J Becker |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1336431055 PECOS PAC ID: 6305089673 Enrollment ID: I20130905000712 |
| Provider Name | Josephine Dunn Junius |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1174840656 PECOS PAC ID: 9133388242 Enrollment ID: I20131007001498 |
| Provider Name | John M Timmons |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609209543 PECOS PAC ID: 3870720246 Enrollment ID: I20131210000241 |
| Provider Name | Karen E Pennings |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588660203 PECOS PAC ID: 0244274215 Enrollment ID: I20141104001967 |
| Provider Name | Amy L. Wingert |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912345992 PECOS PAC ID: 9739320474 Enrollment ID: I20141203002141 |
| Provider Name | Robyn Mellang |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1891184255 PECOS PAC ID: 9234458852 Enrollment ID: I20150504001196 |
| Provider Name | Geri M Bunkers |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1770905580 PECOS PAC ID: 1153554092 Enrollment ID: I20151001002940 |
| Provider Name | Amber Van Voorst |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1134543580 PECOS PAC ID: 9638392012 Enrollment ID: I20160714002228 |
| Provider Name | Justin L Phelan |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1588181929 PECOS PAC ID: 3274891387 Enrollment ID: I20171219002223 |
| Provider Name | Amy M Waterman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104335496 PECOS PAC ID: 4385903640 Enrollment ID: I20180111001616 |
| Provider Name | Jolene R Lucht |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1922584036 PECOS PAC ID: 5890048847 Enrollment ID: I20181022002674 |
| Provider Name | Michael W Grevengoed |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356837579 PECOS PAC ID: 1456695329 Enrollment ID: I20181204000268 |
| Provider Name | Keith E Begeman |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1780142372 PECOS PAC ID: 3072854454 Enrollment ID: I20190411002884 |
| Provider Name | Nicholas A Vust |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891348926 PECOS PAC ID: 1456788611 Enrollment ID: I20200227001819 |
| Provider Name | Chase Hurtig |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1740782242 PECOS PAC ID: 3971866815 Enrollment ID: I20200409001096 |
| Provider Name | Holly Marie Klink |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497255509 PECOS PAC ID: 6406101807 Enrollment ID: I20200419000090 |
| Provider Name | Rachel Van Briesen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275124372 PECOS PAC ID: 0042610362 Enrollment ID: I20210608002663 |
| Provider Name | Samantha Walters |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306599741 PECOS PAC ID: 8820481971 Enrollment ID: I20220212000202 |
| Provider Name | Nicole M Voigt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265166755 PECOS PAC ID: 8820473192 Enrollment ID: I20220922002268 |
| Provider Name | Tamra Kristine Huff |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194450379 PECOS PAC ID: 3072981422 Enrollment ID: I20221116002185 |
| Provider Name | Piet Koene |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003549056 PECOS PAC ID: 6507234317 Enrollment ID: I20221129002817 |
| Provider Name | Cynthia M Kantos |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1780023556 PECOS PAC ID: 0547674129 Enrollment ID: I20221202002851 |
| Provider Name | Brett W Hutton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568184349 PECOS PAC ID: 0840664843 Enrollment ID: I20230314002136 |
| Provider Name | Wyatt Myron Cook |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881399491 PECOS PAC ID: 4183082100 Enrollment ID: I20230623002282 |
| Provider Name | Samantha Anne Smits |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821772278 PECOS PAC ID: 7012378367 Enrollment ID: I20230802002732 |
| Provider Name | Jared Laverne Harwood |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1942393954 PECOS PAC ID: 7113161225 Enrollment ID: I20240118003556 |
| Provider Name | Megan Rens |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1578248548 PECOS PAC ID: 1456795517 Enrollment ID: I20240216000239 |
| Provider Name | Amanda Ann Fedders |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1871334755 PECOS PAC ID: 3870039175 Enrollment ID: I20240723002770 |
| Provider Name | Mia I Turgeon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235987041 PECOS PAC ID: 0840738332 Enrollment ID: I20240815000290 |
| Provider Name | Salina A Neuman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972081453 PECOS PAC ID: 5193064111 Enrollment ID: I20241217002418 |
| Provider Name | Jodi Lynn Peterson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033710736 PECOS PAC ID: 9436562097 Enrollment ID: I20250204003858 |
| Provider Name | Beth Ann Goetschius |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326856154 PECOS PAC ID: 4486174240 Enrollment ID: I20250224001544 |
| Provider Name | Molly Taylor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790441103 PECOS PAC ID: 8325560907 Enrollment ID: I20250324002589 |
| Provider Name | John Hallgren |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710973029 PECOS PAC ID: 5294874574 Enrollment ID: I20250528003211 |