NPIMap

Organization Active NPI

Deer River Healthcare Center Inc

  • Multi-Specialty Clinic/Center
  • Grand Rapids, MN
National Provider Identifier
1063942977
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
DEER RIVER HEALTHCARE CENTER INC
Practice address
1542 Golf Course Rd Ste 202
Grand Rapids, MN 55744-3557
Phone
(218) 999-7000
NPI assigned
Jun 13, 2017
Organization subpart
Yes
Parent organization
ST. MARY'S DULUTH CLINIC HEALTH SYSTEMAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Marsha Green
Title
Coo
Phone
(218) 246-4200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X Primary

Addresses

Primary practice location

1542 Golf Course Rd Ste 202
Grand Rapids, MN 55744-3557

Mailing address

1542 Golf Course Rd Ste 202
Grand Rapids, MN 55744-3557
Phone (218) 999-7000

Other names 2

  • Essentia Health Grand Rapids Clinic Doing business as
  • Essentia Health Grand Rapids Specialty Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040427000428 MN Part B Supplier - Clinic/Group Practice 1850388448 Receives reassigned benefits from 181 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Deer River, MN

Other NPIs on the same Medicare enrollment 4

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

National Provider Directory

National Provider Directory
Part of
St Marys Duluth Clinic Health System

Locations

1542 Golf Course Rd
Ste 202
Grand Rapids, MN 55744
Phone (218) 327-7973

Practitioners & affiliated clinicians

Practitioners 12

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": "1497312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1063942977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1542 GOLF COURSE RD STE 202",
            "city": "GRAND RAPIDS",
            "state": "MN",
            "postal_code": "557443557",
            "telephone_number": "218-999-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1542 GOLF COURSE RD STE 202",
            "city": "GRAND RAPIDS",
            "state": "MN",
            "postal_code": "557443557",
            "telephone_number": "218-999-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEER RIVER HEALTHCARE CENTER INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ST. MARY'S DULUTH CLINIC HEALTH SYSTEM",
        "enumeration_date": "2017-06-13",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "GREEN",
        "authorized_official_first_name": "MARSHA",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "218-246-4200"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Essentia Health Grand Rapids Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Essentia Health Grand Rapids Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Essentia Health Grand Rapids Specialty Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Grand Rapids, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.