NPIMap

Organization Active NPI

Christian Unity Hospital Corporation

Doing business as Park River Family Clinic

  • Rural Health Clinic/Center
  • Park River, ND
National Provider Identifier
1821637828
Registry record updated Jul 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
CHRISTIAN UNITY HOSPITAL CORPORATION
Doing business as
Park River Family Clinic
Practice address
503 Park St W Ste B
Park River, ND 58270-4138
Phone
(701) 284-6663
Fax
(701) 284-6923
NPI assigned
Dec 23, 2019
Last updated
Jul 29, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
CHRISTIAN UNITY HOSPITAL CORPORATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 29, 2026

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

Authorized official

Name
Darla M Hanson
Title
Supervisor
Phone
(701) 352-1620

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X NU
Rural Health Clinic/Center 261QR1300X NU Primary

Addresses

Primary practice location

503 Park St W Ste B
Park River, ND 58270-4138

Mailing address

164 W 13TH St
Grafton, ND 58237-1826
Phone (701) 352-1620

Other names 1

  • Park River Family Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20041006000540 ND Part B Supplier - Clinic/Group Practice 8123925401 Receives reassigned benefits from 30 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Grafton, ND; Park River, ND
O20200817003106 ND Part A Provider - Rural Health Clinic 8123925401 Practice locations: Park River, ND

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1821637828. Details of each certification follow.

Rural health clinic certification: CCN 358507

Legal name
CHRISTIAN UNITY HOSPITAL CORPORATION
Doing business as
PARK RIVER FAMILY CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Mar 1, 2021
Last certification
Mar 1, 2021
Ownership / control type
2B
Organization structure
CorporationNon-profit
Incorporated
Mar 24, 1970 in ND
Enrollment address
503 Park St W
Ste B
Park River, ND 58270-4138
Related CCNs
351320

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 3

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

Other NPIs on the same Medicare enrollment 1

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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
35D1092876Park River Family Clinic503 Park St, Park River, ND 58270Certificate of waiverDec 3, 2026

National Provider Directory

National Provider Directory
Tax ID family
Christian Unity Hospital Corp4 organizations share this tax ID, including this one
Part of
Christian Unity Hospital Corp

Other organizations with this tax ID 3

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

Ownership & related parties

All disclosed owners & managing parties 14

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Russell Carignan Individual Corporate DirectorBoard Trustee Dec 15, 2015 100%
Todd Morgan Individual Corporate DirectorBoard Trustee Nov 5, 2013 100%
Josephine Petersen Individual Corporate OfficerPresident Sep 27, 2007 100%
Heidi Paulson Individual Corporate DirectorBoard Trustee Nov 5, 2013 100%
Paul Mohagen Individual Corporate DirectorBoard Trustee Dec 14, 2017 100%
Chris Gaule Individual Corporate OfficerVice President Oct 25, 2011 100%
Darla Hanson Individual W-2 Managing EmployeeBusiness Services Supervisor/Billin Mar 1, 2000
Roger Gorder Individual Corporate DirectorBoard Trustee Oct 25, 2011 100%
Christian Unity Hospital Corporation Organization, Grafton, ND Corporation Operational/Managerial Control Mar 1, 2020 100%
Amy Vollrath Individual Corporate OfficerSecretary/Treasurer Oct 30, 2012 100%
Mark Bertilrud Individual W-2 Managing EmployeeAd; Jun 1, 2026 100%
Bradley Wurgler Individual Corporate OfficerCfo May 18, 2020 49%
W-2 Managing EmployeeCfo May 18, 2020 100%
Matthew S Viscito Individual Corporate DirectorBoard Trustee Jun 27, 2017 100%
Thomas Campbell Individual Corporate DirectorBoard Trustee Mar 3, 2015 100%

Owners & managing parties with NPI records 4

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

All facility ownership & control disclosures 3

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

FacilityTypeRoleSince
Unity Medical CenterGrafton, ND, CCN 351320 Hospital 5% Or Greater Direct Ownership Interest Feb 3, 1971
Unity Medical CenterGrafton, ND, CCN 35Z320 Hospital 5% Or Greater Direct Ownership Interest Feb 3, 1971
Unity Medical Center/Grafton Family ClinicGrafton, ND, CCN 353978 Rural health clinic 5% Or Greater Direct Ownership Interest Feb 3, 1971

Owned or controlled facilities with NPI records 3

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

Facilities with the same owner 3

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

Practitioners & affiliated clinicians

Practitioners 12

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.

NPI Registry JSON

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

{
    "created_epoch": "1577059200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1785283200000",
    "number": "1821637828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "164 W 13TH ST",
            "city": "GRAFTON",
            "state": "ND",
            "postal_code": "582371826",
            "telephone_number": "701-352-1620",
            "fax_number": "701-352-9397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "503 PARK ST W STE B",
            "city": "PARK RIVER",
            "state": "ND",
            "postal_code": "582704138",
            "telephone_number": "701-284-6663",
            "fax_number": "701-284-6923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHRISTIAN UNITY HOSPITAL CORPORATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CHRISTIAN UNITY HOSPITAL CORPORATION",
        "enumeration_date": "2019-12-23",
        "last_updated": "2026-07-29",
        "certification_date": "2026-07-29",
        "status": "A",
        "authorized_official_last_name": "HANSON",
        "authorized_official_first_name": "DARLA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "SUPERVISOR",
        "authorized_official_telephone_number": "701-352-1620"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Park River Family Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Park River Family Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Park River, ND

Sources for this page

Verify at the official NPI Registry.