CMS-1500 Box 24J / 33a • NPI
1093090342
Type 2 Organization (Box 32a/33a)
HIPAA NUCC Taxonomy • CMS Code
207Q00000X (CMS 08)
Board-Certified Family Medicine Physician (All-Ages Primary Care Doctor)
Box 32 Service Location & ZIP+4
1420 W 22NDST STE 104, SIOUX FALLS, SD, 57105-1507
✓ 9-Digit EDI 837 ZIP+4 (57105-1507)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1093090342 (SANFORD MEDICAL CENTER) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).
CMS Medicare Order & Referring PECOS Eligibility
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1093090342 (NPI-2 Organization / Facility) |
|---|---|
| Provider / Legal Name | SANFORD MEDICAL CENTER |
| Plain-English Specialty | Board-Certified Family Medicine Physician (All-Ages Primary Care Doctor) NUCC Code: 207Q00000X (Family Medicine) |
| Certifying / Licensing Body | American Board of Family Medicine (ABFM) |
| Practice Location Address | 1420 W 22NDST STE 104, SIOUX FALLS, SD, 57105-1507 |
| Practice Telephone / Fax | Tel: (605) 328-4897 | Fax: (605) 328-1198 |
| Administrative Mailing Address | PO BOX 5074, SIOUX FALLS, SD, 57117-5074 |
| Enumeration & Last Sync | Enumerated: 2011-10-19 | CMS Record Updated: 2026-10-26 |
| Authorized Official | TONY MORRISON (VP, Chief Rev Cycle Officer) |
Clinic Location, Accessibility & Directions
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Plain-English Taxonomy & CMS Crosswalk (207Q00000X)
What Does Taxonomy Code 207Q00000X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 207Q00000X translates to:
"Board-Certified Family Medicine Physician (All-Ages Primary Care Doctor)"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (SANFORD MEDICAL CENTER)
Typical CPT / Diagnostic Procedures:- Comprehensive Annual Preventive Physical Examination & Cardiometabolic Screening
- Outpatient ECG / EKG Interpretation (CPT 93000) & Ambulatory BP Monitoring
- Point-of-Care HbA1c, Lipid Panel, Urinalysis & BMI Risk Stratification
- Minor Office Procedures: Wound Suturing, Abscess Drainage & Joint Injections
- Adult & Pediatric Immunization Administration (Tetanus/Tdap, Influenza, HPV)
- Metformin, SGLT2 Inhibitors & GLP-1 Receptor Agonists (Type 2 Diabetes)
- Lisinopril, Losartan & Amlodipine (First-Line Hypertension Management)
- Atorvastatin & Rosuvastatin (Cardiovascular Lipid Optimization)
- Nitrofurantoin, Trimethoprim-Sulfamethoxazole & Ciprofloxacin (Outpatient UTIs)
All Registered NUCC Taxonomies & State Licenses
| Taxonomy Code & Plain-English Description | State License & Primary Status |
|---|---|
207N00000X — DermatologyPlain English: Board-Certified Dermatologist (Skin, Hair & Nail Medical/Surgical Specialist) | State: N/A | License: Verified | Primary: Secondary |
207Q00000X — Family MedicinePlain English: Board-Certified Family Medicine Physician (All-Ages Primary Care Doctor) | State: N/A | License: Verified | Primary: Yes (Primary) |
207R00000X — Internal MedicinePlain English: Board-Certified Internist (Adult Diagnostic & Chronic Disease Physician) | State: N/A | License: Verified | Primary: Secondary |
207RN0300X — Internal Medicine, NephrologyPlain English: Board-Certified Nephrologist (Kidney Function, Stones & Dialysis Specialist) | State: N/A | License: Verified | Primary: Secondary |
207T00000X — Neurological SurgeryPlain English: Board-Certified Neurosurgeon (Brain, Cranial & Spine Surgeon) | State: N/A | License: Verified | Primary: Secondary |
207V00000X — Obstetrics & GynecologyPlain English: Board-Certified Obstetrician & Gynecologist (Women's Health & Pregnancy Doctor) | State: N/A | License: Verified | Primary: Secondary |
207W00000X — OphthalmologyPlain English: Board-Certified in Ophthalmology (Medical & Microsurgical Eye Doctor) | State: N/A | License: Verified | Primary: Secondary |
207X00000X — Orthopaedic SurgeryPlain English: Board-Certified Orthopedic Surgeon (Bone, Joint, Spine & Sports Injury Surgeon) | State: N/A | License: Verified | Primary: Secondary |
208100000X — Physical Medicine & RehabilitationPlain English: Licensed & Credentialed Allopathic & Osteopathic Physicians — Physical Medicine & Rehabilitation | State: N/A | License: Verified | Primary: Secondary |
208600000X — SurgeryPlain English: Board-Certified Orthopedic Surgeon (Bone, Joint, Spine & Sports Injury Surgeon) | State: N/A | License: Verified | Primary: Secondary |
2086S0129X — Plain English: Licensed & Credentialed Allopathic & Osteopathic Physicians — Surgery — Vascular Surgery | State: N/A | License: Verified | Primary: Secondary |
208800000X — UrologyPlain English: Board-Certified Urologist (Urinary Tract, Kidney Stone & Prostate Surgeon) | State: N/A | License: Verified | Primary: Secondary |
282N00000X — General Acute Care HospitalPlain English: Accredited Inpatient Medical & Surgical Hospital (24/7 Emergency & ICU Care) | State: SD | License: 10564 | Primary: Secondary |
363A00000X — Physician AssistantPlain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Physician Assistant | State: N/A | License: Verified | Primary: Secondary |
363L00000X — Nurse PractitionerPlain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner | State: N/A | License: Verified | Primary: Secondary |
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