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Organization Active NPI

Graceville Health Center

  • Rural Health Clinic/Center
  • Graceville, MN
National Provider Identifier
1013976281
Registry record updated Feb 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
GRACEVILLE HEALTH CENTER
Practice address
115 W 2ND St
Graceville, MN 56240-4803
Phone
(320) 748-7243
Fax
(320) 748-8204
NPI assigned
Mar 17, 2006
Organization subpart
Yes
Parent organization
ESSENTIA HEALTHAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 5, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Alan Hurley
Title
Coo
Phone
(701) 364-7667

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

115 W 2ND St
Graceville, MN 56240-4803

Mailing address

PO Box 157
115 W 2ND St
Graceville, MN 56240-4803
Phone (320) 748-7243

Other identifiers 1

IdentifierTypeStateIssuer
822523100MedicaidMN

Other names 1

  • Essentia Health - Graceville Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031103000694 MN Part B Supplier - Clinic/Group Practice 4385556885 Receives reassigned benefits from 36 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Graceville, MN
O20070305000072 MN Part A Provider - Rural Health Clinic 4385556885 Practice locations: Graceville, MN

Rural health clinic certification: CCN 243997B

Legal name
GRACEVILLE HEALTH CENTER
Doing business as
ESSENTIA HEALTH GRACEVILLE CLINIC
Organization structure
CorporationNon-profit
Enrollment address
115 W 2ND St
Graceville, MN 56240-4845

Rural health clinic certification: CCN 243997

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
ESSENTIA HEALTH GRACEVILLE CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Aug 6, 1996
Last certification
Jul 6, 2017
Ownership / control type
2B
Facility address
115 West Second Street
Graceville, MN 56240
Related CCNs
241321

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 17

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Stefanie Gefroh Ellison Individual Corporate OfficerPresident Aug 12, 2024
Tim D Heilman Individual Corporate DirectorBoard Member Jan 1, 2020
Marc Adams Individual Corporate DirectorBoard Member Jan 1, 2026
Mark Krejci Individual Corporate DirectorBoard Member Jan 1, 2026
Kimberly Pladson Individual Corporate DirectorBoard Member Jan 1, 2025
Essentia Health Organization, Duluth, MN Non-profit 5% Or Greater Direct Ownership Interest Jul 1, 2023 100%
James M Christensen Individual Corporate DirectorBoard Member Jan 1, 2020
Debra Jean Stueve Individual W-2 Managing EmployeeAdministrator Feb 26, 2024
Kevin S Boren Individual Corporate OfficerTreasurer Sep 29, 2025
Taylor Grant Mertz Individual Corporate DirectorBoard Member May 17, 2022
Anderson Saint Georges Individual Corporate DirectorBoard Member Jan 1, 2025
Michael Watters Individual Corporate OfficerSecretary Jul 1, 2023
Alan J Hurley Individual Corporate OfficerCoo May 18, 2023
W-2 Managing EmployeeCoo May 18, 2023
Benjamin Cody Smith Individual Corporate DirectorBoard Member May 17, 2022
Douglas J Arvin Individual Corporate OfficerVP of Finance / Cfo May 18, 2023
W-2 Managing EmployeeVP of Finance May 18, 2023
Laurie Ann Lewandowski Individual Corporate DirectorBoard Member Jan 1, 2017
Innovis Health LLC Organization, Fargo, ND LLC, Non-profit Operational/Managerial Control Jan 1, 2017

Owners & managing parties with NPI records 11

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 50

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 50

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1142553600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1770249600000",
    "number": "1013976281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 157",
            "address_2": "115 W 2ND ST",
            "city": "GRACEVILLE",
            "state": "MN",
            "postal_code": "562404803",
            "telephone_number": "320-748-7243",
            "fax_number": "320-748-8204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 W 2ND ST",
            "city": "GRACEVILLE",
            "state": "MN",
            "postal_code": "562404803",
            "telephone_number": "320-748-7243",
            "fax_number": "320-748-8204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACEVILLE HEALTH CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ESSENTIA HEALTH",
        "enumeration_date": "2006-03-17",
        "last_updated": "2026-02-05",
        "certification_date": "2026-02-05",
        "status": "A",
        "authorized_official_last_name": "HURLEY",
        "authorized_official_first_name": "ALAN",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "701-364-7667"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "822523100",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Essentia Health - Graceville Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Graceville, MN

Sources for this page

Verify at the official NPI Registry.