| Sanford Health Network | |
|
111 E 2nd St Ponca NE 68770-7208 | |
| (402) 755-2231 | |
| (402) 755-4100 |
| Full Name | Sanford Health Network |
|---|---|
| Speciality | Clinic/Center |
| Location | 111 E 2nd St, Ponca, Nebraska |
| 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) 328-6585 | Sanford Health Network 111 E 2nd St Ponca NE 68770-7208 Ph: (402) 755-2231 |
| NPI Number | 1720689235 |
|---|---|
| Provider Enumeration Date | 11/03/2020 |
| Last Update Date | 11/03/2020 |
| Medicare PECOS PAC ID | 6800707100 |
|---|---|
| Medicare Enrollment ID | O20210820000824 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720689235 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
| Provider Name | Mary J Olson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1013914597 PECOS PAC ID: 8426030222 Enrollment ID: I20210823000143 |
| Provider Name | Carla L Uhl |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457013674 PECOS PAC ID: 6800282377 Enrollment ID: I20230410001052 |
| Provider Name | Quinn Cannon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043873243 PECOS PAC ID: 2365851474 Enrollment ID: I20230802000336 |
Ponca Mercy Medical Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 111 E 2nd St, Ponca, NE 68770 Phone: 402-755-2231 Fax: 402-755-4100 | |
St Lukes Health Resources Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 111 Second Street, Ponca, NE 68770 Phone: 402-755-2231 Fax: 402-755-4100 |