Graceville Health Center

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

Legal business name

GRACEVILLE HEALTH CENTER

Doing business as

Essentia Health - Chokio Clinic

Practice address

104 Main Street
Chokio, MN 56221

Phone

(320) 324-7500

Fax

(320) 324-7563

NPI assigned

Mar 21, 2006

Last updated

Feb 11, 2016By the provider in NPPES

Organization subpart

Yes

Parent organization

GRACEVILLE HEALTH CENTERAs reported in NPPES

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

Authorized official

Name

Kim Bodensteiner

Title

Cfo

Phone

(218) 435-7633

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Essentia Health - Chokio Clinic Doing business as

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Other NPIs on the same Medicare enrollment 3

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

• Graceville Health Center

  dba Essentia Health - Graceville Clinic

  • Rural Health Clinic/Center
  • Graceville, MN
  • NPI 1013976281

  O20031103000694

  Same enrollment
• Graceville Health Center

  dba Essentia Health - Grace Home

  • Skilled Nursing Facility
  • Graceville, MN
  • NPI 1699744128

  O20031103000694

  Same enrollment
• Graceville Health Center

  dba Essentia Health - Holy Trinity Hospital

  • Critical Access Hospital
  • Graceville, MN
  • NPI 1982673620

  O20031103000694

  Same enrollment

Part of

Graceville Health Cente

Practitioners 1

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.

• John K Erie, MD

  • Anesthesiology Physician
  • Fargo, ND
  • NPI 1336189539
  NPD

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

{
    "created_epoch": "1142899200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1455148800000",
    "number": "1487613287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 157",
            "address_2": "115 W 2ND ST",
            "city": "GRACEVILLE",
            "state": "MN",
            "postal_code": "562404847",
            "telephone_number": "320-748-7223",
            "fax_number": "320-748-7225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 MAIN STREET",
            "city": "CHOKIO",
            "state": "MN",
            "postal_code": "56221",
            "telephone_number": "320-324-7500",
            "fax_number": "320-324-7563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACEVILLE HEALTH CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GRACEVILLE HEALTH CENTER",
        "enumeration_date": "2006-03-21",
        "last_updated": "2016-02-11",
        "status": "A",
        "authorized_official_last_name": "BODENSTEINER",
        "authorized_official_first_name": "KIM",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "218-435-7633"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102823500",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Essentia Health - Chokio Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Chokio-Alberta Public School District #771

• Rural Health Clinic/Center in Chokio, MN
• Providers in Chokio, MN by specialty
• Rural Health Clinic/Center in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2016; 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.