NPIMap

Organization Active NPI

Carris Health LLC

Doing business as CentraCare Willmar Surgery Center

  • Ambulatory Surgical Clinic/Center
  • Willmar, MN
National Provider Identifier
1902319478
Registry record updated Sep 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
CARRIS HEALTH LLC
Doing business as
CentraCare Willmar Surgery Center
Practice address
1310 1St St S
Willmar, MN 56201-4242
Phone
(320) 235-6506
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
Ambulatory Surgical Clinic/Center 261QA1903X Primary

Addresses

Primary practice location

1310 1St St S
Willmar, MN 56201-4242

Mailing address

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

Other names 1

  • CentraCare Willmar Surgery Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20171221001101 MN Part B Supplier - Ambulatory Surgical Center 7012274228 Practice locations: Willmar, MN

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: Ambulatory surgical center

Medicare Care Compare
Listed as
Carris Health LLCCCN 24C0001010
Medicare certification status
ActiveFrom the Provider of Services file

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
24D0405434Centracare Willmar Surgery Center1310 1St St South, Willmar, MN 56201Certificate of waiverAug 31, 2026

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.

Member organizations 14

Organizations listed as members of this organization in the National Provider Directory.

View all 14

Locations

1310 1st St S
Willmar, MN 56201
Phone (320) 235-6506

Ownership & related parties

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.

Practitioners & affiliated clinicians

Practitioners 5

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": "1510012800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1789344000000",
    "number": "1902319478",
    "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": "1310 1ST ST S",
            "city": "WILLMAR",
            "state": "MN",
            "postal_code": "562014242",
            "telephone_number": "320-235-6506"
        }
    ],
    "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": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CentraCare Willmar Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Willmar, MN

Sources for this page

Verify at the official NPI Registry.