NPIMap

Organization Active NPI

Altru Health System

Doing business as Altru 1300 Columbia

  • Clinic/Center
  • Grand Forks, ND
National Provider Identifier
1043309552
Registry record updated Feb 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
ALTRU HEALTH SYSTEM
Doing business as
Altru 1300 Columbia
Altru Clinic
Practice address
1300 S Columbia Rd
Grand Forks, ND 58201-4012
Phone
(701) 780-5000
NPI assigned
Oct 12, 2006
Last updated
Feb 2, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2026

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

Authorized official

Name
Derek Goebel
Title
Chief Financial Officer
Phone
(701) 780-1470

Specialties & licenses 10

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207K00000X
Anesthesiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207L00000X
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Hematology & Oncology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RH0003X
Obstetrics & Gynecology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207V00000X
Orthopaedic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207X00000X
Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208600000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208G00000X
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

1300 S Columbia Rd
Grand Forks, ND 58201-4012

Mailing address

PO Box 860939
Minneapolis, MN 55486-0939
Phone (701) 780-5000

Other practice location 1

3165 DeMers Ave
Grand Forks, ND 58201-4049
Phone (701) 780-6000

Other practice location 2

500 1st Ave S Ste 2
Grand Forks, ND 58201-4565
Phone (701) 780-5000

Other practice location 3

4 N Park St
Northwood, ND 58267-4102
Phone (701) 587-6060

Other practice location 4

164 W 13th St
Grafton, ND 58237-1826
Phone (701) 780-6000

Other practice location 5

1003 N Main St
Drayton, ND 58225-4624
Phone (701) 454-3311

Other practice location 6

1001 7th St NE
Devils Lake, ND 58301-2719
Phone (701) 662-2157

Other practice location 7

301 Mountain St E Ste A
Cavalier, ND 58220-4015
Phone (701) 265-8338

Other practice location 8

4401 S 11th St Ste 1000
Grand Forks, ND 58201-7238
Phone (701) 732-7620

Other practice location 9

960 S Columbia Rd
Grand Forks, ND 58201-4030
Phone (701) 780-5400

Other practice location 10

4350 S Washington St Ste 114
Grand Forks, ND 58201-7185
Phone (701) 780-5000

Other practice location 11

725 Hamline St
Grand Forks, ND 58203-2819
Phone (701) 780-6800

Other practice location 12

300 W Good Samaritan Dr
Warren, MN 56762-1412
Phone (701) 780-5000

Other practice location 13

715 Delmore Dr
Roseau, MN 56751-1534
Phone (218) 463-2500

Other practice location 14

1201 11th Ave SW
Minot, ND 58701-4207
Phone (701) 858-6700 ext. 6750

Other practice location 15

1010 S Birch Ave
Hallock, MN 56728-4215
Phone (701) 780-5000

Other practice location 16

1380 S Columbia Rd
Grand Forks, ND 58201-4059
Phone (701) 795-2000

Other practice location 17

4440 S Washington St
Grand Forks, ND 58201-7245
Phone (701) 732-7000

Other practice location 18

860 S Columbia Rd
Grand Forks, ND 58201-4028
Phone (701) 780-6697

Other names 2

  • Altru 1300 Columbia Doing business as
  • Altru Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, ND3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20031110000135 MN Part B Supplier - Clinic/Group Practice 1355251604 Receives reassigned benefits from 217 practitioners
8 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Hallock, MN; Warroad, MN; Warren, MN; Thief River Falls, MN; Saint Paul, MN; Roseville, MN; Roseau, MN; Red Lake Falls, MN…
O20031111000714 ND Part B Supplier - Clinic/Group Practice 1355251604 Receives reassigned benefits from 727 practitioners
3 other NPIs on this enrollment
Practice locations: Grand Forks, ND; Minot, ND; Northwood, ND; West Fargo, ND; Cavalier, ND; Devils Lake, ND; Drayton, ND; Grafton, ND…
O20111020000173 MN Part B Supplier - Hospital Department(S) 1355251604 Receives reassigned benefits from 213 practitioners
1 other NPI on this enrollment
Practice locations: Roseville, MN

Other NPIs with the same Medicare PAC ID 13

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

View all 13

Other NPIs on the same Medicare enrollment 8

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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
35D2317372Altru Clinic1300 S Columbia Rd, Grand Forks, ND 58201Provider-performed microscopyJan 22, 2027

National Provider Directory

National Provider Directory

Locations

1003 N Main St
Crookston, MN 56716

19120 200th St
Greenbush, MN 56726
Phone (218) 782-2400

701 E Rosser Ave
Bismarck, ND 58501
Phone (701) 751-6755

1001 7th St NE
Fl 1
Devils Lake, ND 58301

333 Eastern Ave
Grafton, ND 58237
Phone (701) 352-1901

701 W 6th St
Grafton, ND 58237
Phone (701) 352-2574

1201 S Columbia Rd
Grand Forks, ND 58201

1202 S Columbia Rd
Grand Forks, ND 58201

1308 S Columbia Rd
Grand Forks, ND 58201

1375 S Columbia Rd
Ste F
Grand Forks, ND 58201

2200 S Washington St
Grand Forks, ND 58201
Phone (701) 330-5269

4350 S Washington St
Ste 112
Grand Forks, ND 58201
Phone (701) 293-9829

4350 S Washington St
Ste 114
Grand Forks, ND 58201
Phone (701) 780-6204

860 S Columbia Rd
Grand Forks, ND 58201
Phone (701) 780-5340

501 E Front St
Larimore, ND 58251
Phone (701) 343-6244

611 Towner Ave
Larimore, ND 58251
Phone (701) 431-2999

Ownership & related parties

All facility ownership & control disclosures 4

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Altru Rehabilitation HospitalGrand Forks, ND, CCN 353027 Hospital 5% Or Greater Direct Ownership Interest (40%) May 24, 2021
Valley Senior Living on ColumbiaGrand Forks, ND, CCN 355067 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Jun 1, 1994
May 21, 2025
Woodside VillageGrand Forks, ND, CCN 355112 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Jun 1, 1994
May 21, 2025
Altru's Home HealthGrand Forks, ND, CCN 357014 Home health agency 5% Or Greater Direct Ownership Interest (100%) Jul 1, 1997

Owned or controlled facilities with NPI records 4

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 999

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 999

NPI Registry JSON

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1769990400000",
    "number": "1043309552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 860939",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554860939",
            "telephone_number": "701-780-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 S COLUMBIA RD",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582014012",
            "telephone_number": "701-780-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3165 DeMers Ave",
            "address_purpose": "LOCATION",
            "city": "Grand Forks",
            "state": "ND",
            "postal_code": "582014049",
            "country_code": "US",
            "telephone_number": "701-780-6000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "500 1st Ave S Ste 2",
            "address_purpose": "LOCATION",
            "city": "Grand Forks",
            "state": "ND",
            "postal_code": "582014565",
            "country_code": "US",
            "telephone_number": "701-780-5000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4 N Park St",
            "address_purpose": "LOCATION",
            "city": "Northwood",
            "state": "ND",
            "postal_code": "582674102",
            "country_code": "US",
            "telephone_number": "701-587-6060",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "164 W 13th St",
            "address_purpose": "LOCATION",
            "city": "Grafton",
            "state": "ND",
            "postal_code": "582371826",
            "country_code": "US",
            "telephone_number": "701-780-6000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1003 N Main St",
            "address_purpose": "LOCATION",
            "city": "Drayton",
            "state": "ND",
            "postal_code": "582254624",
            "country_code": "US",
            "telephone_number": "701-454-3311",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1001 7th St NE",
            "address_purpose": "LOCATION",
            "city": "Devils Lake",
            "state": "ND",
            "postal_code": "583012719",
            "country_code": "US",
            "telephone_number": "701-662-2157",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "301 Mountain St E Ste A",
            "address_purpose": "LOCATION",
            "city": "Cavalier",
            "state": "ND",
            "postal_code": "582204015",
            "country_code": "US",
            "telephone_number": "701-265-8338",
            "fax_number": "701-265-8338",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4401 S 11th St Ste 1000",
            "address_purpose": "LOCATION",
            "city": "Grand Forks",
            "state": "ND",
            "postal_code": "582017238",
            "country_code": "US",
            "telephone_number": "701-732-7620",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "960 S Columbia Rd",
            "address_purpose": "LOCATION",
            "city": "Grand Forks",
            "state": "ND",
            "postal_code": "582014030",
            "country_code": "US",
            "telephone_number": "701-780-5400",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4350 S Washington St Ste 114",
            "address_purpose": "LOCATION",
            "city": "Grand Forks",
            "state": "ND",
            "postal_code": "582017185",
            "country_code": "US",
            "telephone_number": "701-780-5000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "725 Hamline St",
            "address_purpose": "LOCATION",
            "city": "Grand Forks",
            "state": "ND",
            "postal_code": "582032819",
            "country_code": "US",
            "telephone_number": "701-780-6800",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "300 W Good Samaritan Dr",
            "address_purpose": "LOCATION",
            "city": "Warren",
            "state": "MN",
            "postal_code": "567621412",
            "country_code": "US",
            "telephone_number": "701-780-5000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "715 Delmore Dr",
            "address_purpose": "LOCATION",
            "city": "Roseau",
            "state": "MN",
            "postal_code": "567511534",
            "country_code": "US",
            "telephone_number": "218-463-2500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1201 11th Ave SW",
            "address_purpose": "LOCATION",
            "city": "Minot",
            "state": "ND",
            "postal_code": "587014207",
            "country_code": "US",
            "telephone_number": "701-858-6700 x6750",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1010 S Birch Ave",
            "address_purpose": "LOCATION",
            "city": "Hallock",
            "state": "MN",
            "postal_code": "567284215",
            "country_code": "US",
            "telephone_number": "701-780-5000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1380 S Columbia Rd",
            "address_purpose": "LOCATION",
            "city": "Grand Forks",
            "state": "ND",
            "postal_code": "582014059",
            "country_code": "US",
            "telephone_number": "701-795-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4440 S Washington St",
            "address_purpose": "LOCATION",
            "city": "Grand Forks",
            "state": "ND",
            "postal_code": "582017245",
            "country_code": "US",
            "telephone_number": "701-732-7000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "860 S Columbia Rd",
            "address_purpose": "LOCATION",
            "city": "Grand Forks",
            "state": "ND",
            "postal_code": "582014028",
            "country_code": "US",
            "telephone_number": "701-780-6697",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ALTRU HEALTH SYSTEM",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-12",
        "last_updated": "2026-02-02",
        "certification_date": "2026-02-02",
        "status": "A",
        "authorized_official_last_name": "GOEBEL",
        "authorized_official_first_name": "DEREK",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "701-780-1470"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Allergy & Immunology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Altru 1300 Columbia",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Altru 1300 Columbia",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Altru Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Grand Forks, ND

Sources for this page

Verify at the official NPI Registry.