NPIMap

Organization Active NPI

Carris Health LLC

Doing business as CentraCare - Rice Memorial Hospital

  • Infusion Therapy Clinic/Center
  • Willmar, MN
National Provider Identifier
1124657150
Registry record updated Sep 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infusion Therapy Clinic/CenterTaxonomy code 261QI0500X
Legal business name
CARRIS HEALTH LLC
Doing business as
CentraCare - Rice Memorial Hospital
Practice address
101 Willmar Ave SW
Willmar, MN 56201-3556
Phone
(320) 231-5000
NPI assigned
Apr 2, 2020
Reactivated
Aug 22, 2024
Last updated
Sep 14, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2026

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

Authorized official

Name
Michael Blair
Title
Cfo
Phone
(320) 255-5665

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infusion Therapy Clinic/Center 261QI0500X Primary

Addresses

Primary practice location

101 Willmar Ave SW
Willmar, MN 56201-3556

Mailing address

PO Box 735820
Chicago, IL 60673-5820
Phone (320) 251-2700

Other names 1

  • CentraCare - Rice Memorial Hospital Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1124657150. Details of each certification follow.

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
LLCNon-profit
Incorporated
Jan 1, 2018 in MN
Enrollment address
301 Becker Ave SW
Willmar, MN 56201-3302
Other Hospital Practice Location
Hospital subgroups
Acute care

Other NPIs on the same Medicare enrollment 1

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Centracare- Rice Memorial HospitalCCN 240088 · All quality measures
Overall star rating
3 of 5
Type
Acute Care Hospitals
Ownership
Government - Local
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

501 2ND St SW Ste 1
Willmar, MN 56201

502 2nd St SW
Ste 1
Willmar, MN 56201
Phone (320) 235-7232

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
Tina SSN May Individual Corporate Director Jun 30, 2025
Michelle Johnson Individual Corporate Director Jul 1, 2021
Thomas Knoblach Individual Corporate Director Jul 1, 2011
Michael a Blair Individual Corporate OfficerSr VP/Cfo Sep 30, 2019
W-2 Managing Employee Sep 30, 2019
Jeffrey Gau Individual Corporate Director Jul 1, 2017
Renee S Frauendienst Individual Corporate Director Jul 1, 2017
Jacob Lyons Individual Corporate Director Jul 1, 2024
Richard Wehseler Individual Corporate Director Jun 30, 2022
Bobbie Bertram Individual Corporate Director Jul 1, 2015
Kenneth D Holmen Individual Corporate OfficerChain Home Office Administrator Dec 31, 2017
Sherri Liebl Individual Corporate DirectorExec Director Revenue Cycle Jul 27, 2020
David Anfinson Individual Corporate Director Jun 30, 2022
Daniel Abdul Individual Corporate Director Jul 1, 2022
James Hebl Individual Corporate Director Jul 1, 2017
Carrie Henning-Smith Individual Corporate Officer Jul 1, 2023
Centracare Health System Organization, Saint Cloud, MN Non-profit 5% Or Greater Direct Ownership Interest Dec 31, 2017 100%
Bryan Rolph Individual Corporate Director Jul 1, 2019

Owners & managing parties with NPI records 7

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

Practitioners & affiliated clinicians

Affiliated clinicians 348

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 348

NPI Registry JSON

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

{
    "created_epoch": "1585785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1789344000000",
    "number": "1124657150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 735820",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606735820",
            "telephone_number": "320-251-2700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 WILLMAR AVE SW",
            "city": "WILLMAR",
            "state": "MN",
            "postal_code": "562013556",
            "telephone_number": "320-231-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARRIS HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-02",
        "last_updated": "2026-09-14",
        "certification_date": "2026-09-14",
        "deactivation_date": "2024-07-31",
        "reactivation_date": "2024-08-22",
        "status": "A",
        "authorized_official_last_name": "BLAIR",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "320-255-5665"
    },
    "taxonomies": [
        {
            "code": "261QI0500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Infusion Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CentraCare - Rice Memorial Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Willmar, MN

Sources for this page

Verify at the official NPI Registry.