Graceville Health Center
Organization Active NPI Skilled Nursing Facility · Graceville, MN
NPI 1699744128 · NPPES record last updated Feb 5, 2026
Key facts
- NPI
- 1699744128
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- License
- 328814 (MN)
- Legal business name
- GRACEVILLE HEALTH CENTER
- Practice address
- 116 W 2ND St
Graceville, MN 56240-4803 - Phone
- (320) 748-7261
- Fax
- (320) 748-8238
- NPI assigned
- Mar 16, 2006
- Organization subpart
- Yes
- Parent organization (as reported)
- ESSENTIA HEALTH
Authorized official
- Name
- Alan Hurley
- Title
- Coo
- Phone
- (701) 364-7667
Owners & managing parties with NPI records 12
-
Jay M Schmidt, M.D.
-
Benjamin C Smith, MD
Other NPIs on the same Medicare enrollment 3
Other NPIs with the same Medicare PAC ID 3
Corporate family (same tax ID) 3
Facilities with the same owner 50
Practitioners 34
-
Kevin D Ballard, NP
-
Erika Marie Caslin, APRN,CNP
-
Hannah Jane Johnson, DNP, APRN, FNP-BC
-
Ashleigh Marie Neuman, FNP-C
-
Jay M Schmidt, M.D.
-
Amee Gibson, DPM
-
Jackie Lea Lindberg, DNP, FNP-C
-
Audrey Jean Marjama, FNP
-
Angela Marie Skyberg, PA-C
-
Rylee Ann Zetocha, APRN, FNP-BC
-
Nicole Lynn Amsbaugh, PA-C
-
Rabiah Ashraf, MD
-
Andranik Bedross, MD
-
Jacqueline Marie Bell, CCC,SLP
-
Terry D Benson, MD
-
Sheila Diane Bullock, FNP-C
-
John K Erie, MD
-
Muhammad Bilal Ibrahim, MBBS
-
Kayli Jo Leverson, PA-C
-
Patrick A Luger, MD
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 24D0715456 | Graceville Health Center Inc | Certificate of waiver | Aug 31, 2026 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in MN
Skilled nursing facility certification: CCN 245579B
- Legal name
- GRACEVILLE HEALTH CENTER
- Doing business as
- ESSENTIA HEALTH GRACE HOME
- Organization structure
- Corporation · Non-profit
- Enrollment address
- 116 W 2ND St
Graceville, MN 56240-7768 - Nursing home name
- ESSENTIA HEALTH GRACE HOME
- Affiliated entity
- ESSENTIA HEALTH
All disclosed owners & managing parties 18
| Name | Role | Since | Share |
|---|---|---|---|
| Stefanie Gefroh Ellison |
Corporate Officer |
Aug 12, 2024 | |
| Tim D Heilman |
Corporate Director |
Jan 1, 2020 | |
| Marc Adams |
Corporate Director |
Jan 1, 2026 | |
| Jay M Schmidt |
Corporate Director |
Jan 1, 2024 | |
| Operational/Managerial Control | Jan 1, 2024 | ||
| Adp of the SNF | Jan 1, 2024 | ||
| Mark Krejci |
Corporate Director |
Jan 1, 2026 | |
| Kimberly Pladson |
Corporate Director |
Jan 1, 2025 | |
| Essentia Health |
5% Or Greater Direct Ownership Interest | Jul 1, 2023 | 100% |
| Adp of the SNF | Jan 29, 2025 | ||
| James M Christensen |
Corporate Director |
Jan 1, 2020 | |
| Debra Jean Stueve |
Operational/Managerial Control | Feb 26, 2024 | |
| Adp of the SNF | Feb 26, 2024 | ||
| Kevin S Boren |
Corporate Officer |
Sep 29, 2025 | |
| Taylor Grant Mertz |
Corporate Director |
May 17, 2022 | |
| Anderson Saint Georges |
Corporate Director |
Jan 1, 2025 | |
| Michael Watters |
Corporate Officer |
Jul 1, 2023 | |
| Alan J Hurley |
Corporate Officer |
May 18, 2023 | |
| Operational/Managerial Control | May 18, 2023 | ||
| Adp of the SNF | May 18, 2023 | ||
| Benjamin Cody Smith |
Corporate Director |
May 17, 2022 | |
| Douglas J Arvin |
Corporate Officer |
May 18, 2023 | |
| Operational/Managerial Control | May 18, 2023 | ||
| Adp of the SNF | May 18, 2023 | ||
| Laurie Ann Lewandowski |
Corporate Director |
Jan 1, 2017 | |
| Innovis Health LLC |
Operational/Managerial Control | Jan 1, 2017 | |
| Adp of the SNF | Jan 29, 2025 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031103000694 | MN | Part B Supplier - Clinic/Group Practice | 4385556885 |
Receives reassigned benefits from 36 practitioners 3 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Graceville, MN |
| O20070301000456 | MN | Part a Provider - Skilled Nursing Facility | 4385556885 | Practice locations: Graceville, MN |
National Provider Directory
- Tax ID family
- Graceville Health Center
Locations
15 10th St S
Wheaton, MN 56296
Phone (320) 563-4554
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 328814 | MN | Yes |
Addresses
Primary practice location
116 W 2ND St
Graceville, MN 56240-4803
Mailing address
PO Box 157
116 W 2ND St
Graceville, MN 56240-4803
Phone (320) 748-7261
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 030525100 | Medicaid | MN | |
| 5A75EGR | Other | MN | BCBSM |
Other names
- Essentia Health - Grace Home
Other providers in Graceville, MN
- City of Graceville
- Graceville Health Center
- Graceville Health Center
- Graceville Health Center
- Graceville Health Center
- Graceville Health Center
- Shelby K Johnson
- Liebe Drug Inc
- Ashleigh Marie Neuman
- Monica Rethke
All providers in Graceville, MN · Skilled Nursing Facility in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 5, 2026. 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.