Carris Health LLC
Organization Active NPI Infusion Therapy Clinic/Center · Willmar, MN
NPI 1124657150 · NPPES record last updated Mar 4, 2025
Key facts
- NPI
- 1124657150
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Infusion Therapy Clinic/Center 261QI0500X
- Legal business name
- CARRIS HEALTH LLC
- Practice address
- 101 Willmar Ave SW
Willmar, MN 56201-3556 - Phone
- (320) 231-5000
- NPI assigned
- Apr 2, 2020
- Reactivated
- Aug 22, 2024
- Organization subpart
- No
Authorized official
- Name
- Michael Blair
- Title
- Cfo
- Phone
- (320) 255-5665
Owners & managing parties with NPI records 7
-
Bobbie Jo Bertram, RN, CNP
-
James Russell Hebl, M.D.
-
Jacob Lyons, MD
-
Bryan P Rolph, MD
Other NPIs on the same Medicare enrollment 1
Affiliated clinicians 348
-
Hawo Haji Abdirahman, CNP
-
Eyas Abla, M.D,
-
Lindsay Sarah Anne Abong, LMFT
-
Scott Matthew Abrams, M.D.
-
Angela Adamek, CNP
-
Heba Hamed Elsayed Afeefy, MD, PHD
-
Zachary Affeldt, MD
-
Oluyemi Adebowale Ajayi, MBBS
-
Hani Shaban Alkhatib, MB, BCH
-
Anthony G Amon, M.D.
-
Mary M Amon, M.D.
-
Amanda Anderson, DO
-
Richard L Aplin, MD
-
Kristel L Arcilla, D.O.
-
Moeed Asghar, MBBS
-
David Asinger, M.D.
-
Ian D Augustin, MD
-
Aaron J Balgaard, M.D.
Medicare Care Compare: Hospital
- Listed as
- Centracare- Rice Memorial Hospital
- Overall star rating
- ★★★☆☆ 3 of 5
- Type
- Acute Care Hospitals
- Ownership
- Government - Local
- Medicare certification status
- Active
- Emergency services
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
Hospital certification: CCN 240088
- Legal name
- CARRIS HEALTH LLC
- Doing business as
- CENTRACARE - RICE MEMORIAL HOSPITAL
- Certification status
- Active
- Provider type (POS)
- Hospital – Short-term
- Participating since
- Jul 1, 1966
- Last certification
- Feb 5, 2015
- Beds
- 136 (128 certified)
- Ownership / control type
- Local
- Most recent change of ownership
- Jan 1, 2018 (1 total)
- Organization structure
- LLC · Non-profit
- Incorporated
- Jan 1, 2018 in MN
- Enrollment address
- 301 Becker Ave SW
Willmar, MN 56201-3302 - Hospital subgroups
- Acute care
All disclosed owners & managing parties 17
| Name | Role | Since | Share |
|---|---|---|---|
| Tina SSN May |
Corporate Director | Jun 30, 2025 | |
| Michelle Johnson |
Corporate Director | Jul 1, 2021 | |
| Thomas Knoblach |
Corporate Director | Jul 1, 2011 | |
| Michael a Blair |
Corporate Officer |
Sep 30, 2019 | |
| W-2 Managing Employee | Sep 30, 2019 | ||
| Jeffrey Gau |
Corporate Director | Jul 1, 2017 | |
| Renee S Frauendienst |
Corporate Director | Jul 1, 2017 | |
| Jacob Lyons |
Corporate Director | Jul 1, 2024 | |
| Richard Wehseler |
Corporate Director | Jun 30, 2022 | |
| Bobbie Bertram |
Corporate Director | Jul 1, 2015 | |
| Kenneth D Holmen |
Corporate Officer |
Dec 31, 2017 | |
| Sherri Liebl |
Corporate Director |
Jul 27, 2020 | |
| David Anfinson |
Corporate Director | Jun 30, 2022 | |
| Daniel Abdul |
Corporate Director | Jul 1, 2022 | |
| James Hebl |
Corporate Director | Jul 1, 2017 | |
| Carrie Henning-Smith |
Corporate Officer | Jul 1, 2023 | |
| Centracare Health System |
5% Or Greater Direct Ownership Interest | Dec 31, 2017 | 100% |
| Bryan Rolph |
Corporate Director | Jul 1, 2019 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20171127001012 | MN | Part a Provider - Hospital | 7012274228 |
1 other NPI on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Willmar, MN |
National Provider Directory
Locations
502 2nd St SW
Ste 1
Willmar, MN 56201
Phone (320) 235-7232
1604 1st St S
Willmar, MN 56201
Phone (320) 231-5039
501 2ND St SW Ste 1
Willmar, MN 56201
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Infusion Therapy Clinic/Center | 261QI0500X | Yes |
Addresses
Primary practice location
101 Willmar Ave SW
Willmar, MN 56201-3556
Mailing address
1406 6TH Ave N
Saint Cloud, MN 56303-1900
Phone (320) 235-4543
Other names
- CentraCare - Rice Memorial Hospital
Other providers in Willmar, MN
- Lee L. Cafferty
- Samuel T. Camp
- Ca Cao
- Tana Denise Carlson
- Carris Health LLC
- Carris Health LLC
- Carris Health LLC
- Carris Health LLC
- Carris Health LLC
- Carris Health LLC
All providers in Willmar, MN · Infusion Therapy Clinic/Center in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 4, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.