NPIMap

Organization Active NPI

Carris Health LLC

Doing business as CentraCare Hospice

  • Community Based Hospice Care Agency
  • Willmar, MN
National Provider Identifier
1306359856
Registry record updated Sep 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
CARRIS HEALTH LLC
Doing business as
CentraCare Hospice
Practice address
325 Willmar Ave SW
Willmar, MN 56201-3502
Phone
(800) 336-7423
NPI assigned
Nov 7, 2017
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
Community Based Hospice Care Agency 251G00000X Primary

Addresses

Primary practice location

325 Willmar Ave SW
Willmar, MN 56201-3502

Mailing address

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

Other names 1

  • CentraCare Hospice Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20171127000432 MN Part A Provider - Hospice 7012274228 Practice locations: Willmar, MN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1306359856. Details of each certification follow.

Hospice certification: CCN 241509

Legal name
CARRIS HEALTH LLC
Doing business as
CENTRACARE HOSPICE
Certification status
Active
Provider type (POS)
Hospice
Participating since
Apr 14, 1987
Last certification
Jul 19, 2017
Ownership / control type
Non-Profit - Private
Organization structure
LLCNon-profit
Enrollment address
325 Willmar Ave SW
Willmar, MN 56201-3502

Other NPIs with the same Medicare PAC ID 3

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

Care Compare: Hospice

Medicare Care Compare
Listed as
Centracare HospiceCCN 241509 · All quality measures
Ownership
Non-Profit
Certified
Apr 14, 1987
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Tax ID family
Carris Health LLC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Member of 1

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

Locations

325 Willmar Ave SW
Willmar, MN 56201
Phone (320) 231-4450

Ownership & related parties

All disclosed owners & managing parties 19

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 EmployeeSr VP/Cfo Sep 30, 2019
Jeffrey Gau Individual Corporate Director Jul 1, 2017
Amy Wendinger Individual W-2 Managing EmployeeAd; Jan 1, 2024
Renee S Frauendienst Individual Corporate Director Jul 1, 2017
Jacob Lyons Individual Corporate Director Jul 1, 2024
Richard Wehseler Individual Corporate Director Jun 30, 2023
Bobbie Bertram Individual Corporate Director Jul 1, 2015
Kenneth D Holmen Individual Corporate OfficerChain Home Office Administrator Jan 1, 2018
Sherri Liebl Individual Corporate DirectorExec Dir of Revenue Cycle Jul 27, 2020
David a Newcomer Individual W-2 Managing EmployeeMD; Jan 1, 2024
David Anfinson Individual Corporate Director Jun 30, 2023
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 Jan 1, 2018 100%
Bryan Rolph Individual Corporate Director Jul 1, 2019

Owners & managing parties with NPI records 8

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

All facility ownership & control disclosures 5

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

FacilityTypeRoleSince
Centracare - RedwoodRedwood Falls, MN, CCN 24Z351 Hospital 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2019
Centracare - RedwoodRedwood Falls, MN, CCN 241351 Hospital 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2019
Centracare Home HealthRedwood Falls, MN, CCN 247229 Home health agency 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2019
Centracare HospiceRedwood Falls, MN, CCN 241517 Hospice 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2019
Centracare - RedwoodRedwood Falls, MN, CCN 243489 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2019

Owned or controlled facilities with NPI records 5

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

Facilities with the same owner 28

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

View all 28

Change-of-ownership history 1

DateEventCounterparty
Jan 1, 2018 Change of OwnershipThis provider was the buyer Rice Hospice ProgramCCN 241509, MN, NPI 1801930995

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

Practitioners & affiliated clinicians

Affiliated clinicians 43

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

View all 43

NPI Registry JSON

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

{
    "created_epoch": "1510012800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1789344000000",
    "number": "1306359856",
    "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": "325 WILLMAR AVE SW",
            "city": "WILLMAR",
            "state": "MN",
            "postal_code": "562013502",
            "telephone_number": "800-336-7423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARRIS HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-07",
        "last_updated": "2026-09-14",
        "certification_date": "2026-09-14",
        "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": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CentraCare Hospice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Willmar, MN

Sources for this page

Verify at the official NPI Registry.