NPIMap

Organization Active NPI

Cook County Hospital District

Doing business as Cook County North Shore Hospital and Care Center

  • Home Health Agency
  • Grand Marais, MN
National Provider Identifier
1942364799
Registry record updated Nov 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
334377 Issued in MN
Legal business name
COOK COUNTY HOSPITAL DISTRICT
Doing business as
Cook County North Shore Hospital and Care Center
Practice address
515 5TH Ave W
Grand Marais, MN 55604-3017
Phone
(218) 387-3040
NPI assigned
Dec 19, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2024

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

Authorized official

Name
Kimber Wraalstad
Title
Ceo/Administrator
Phone
(218) 387-3260

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 334377 MN Primary

Addresses

Primary practice location

515 5TH Ave W
Grand Marais, MN 55604-3017

Mailing address

515 5TH Ave W
Grand Marais, MN 55604-3017
Phone (218) 387-3040

Other identifiers 2

IdentifierTypeStateIssuer
3657451000MedicaidMN
1658HCOOtherMNBCBS OF MN

Other names 1

  • Cook County North Shore Hospital and Care Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040415000850 MN Part A Provider - Home Health Agency 4284629742 Practice locations: Grand Marais, MN

Home health agency certification: CCN 247004

Legal name
COOK COUNTY HOSPITAL DISTRICT
Doing business as
NORTH SHORE HEALTH
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Mar 15, 1994
Last certification
Jun 20, 2019
Ownership / control type
Government Operated
Organization structure
GovernmentNon-profit
Enrollment address
515 5TH Ave W
Grand Marais, MN 55604-3017

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: Home health agency

Medicare Care Compare
Listed as
North Shore HealthCCN 247004 · All quality measures
Ownership
Government Operated
Certified
Mar 15, 1994
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Home health aide, Physical therapy, Occupational therapy

National Provider Directory

National Provider Directory
Tax ID family
Cook County North Shore4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

515 5th Ave W
Grand Marais, MN 55604
Phone (218) 387-3040

Ownership & related parties

All disclosed owners & managing parties 2

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

NameRoleSinceShare
Kimber L Wraalstad Individual Operational/Managerial ControlHospital Administrator Aug 23, 2010
Cook County Hospital District Organization, Grand Marais, MN 5% Or Greater Direct Ownership Interest Jan 1, 1996

Owners & managing parties with NPI records 3

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
North Shore HealthGrand Marais, MN, CCN 241317 Hospital Operational/Managerial Control Sep 4, 2009
North Shore HealthGrand Marais, MN, CCN 24Z317 Hospital Operational/Managerial Control Mar 3, 2010
North Shore HealthGrand Marais, MN, CCN 245384 Skilled nursing facility Operational/Managerial Control (100%) Jan 1, 1987

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.

NPI Registry JSON

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730419200000",
    "number": "1942364799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 5TH AVE W",
            "city": "GRAND MARAIS",
            "state": "MN",
            "postal_code": "556043017",
            "telephone_number": "218-387-3040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 5TH AVE W",
            "city": "GRAND MARAIS",
            "state": "MN",
            "postal_code": "556043017",
            "telephone_number": "218-387-3040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COOK COUNTY HOSPITAL DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-19",
        "last_updated": "2024-11-01",
        "certification_date": "2024-11-01",
        "status": "A",
        "authorized_official_last_name": "WRAALSTAD",
        "authorized_official_first_name": "KIMBER",
        "authorized_official_title_or_position": "CEO/ADMINISTRATOR",
        "authorized_official_telephone_number": "218-387-3260"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "MN",
            "license": "334377",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3657451000",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF MN",
            "identifier": "1658HCO",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cook County North Shore Hospital and Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Grand Marais, MN

Sources for this page

Verify at the official NPI Registry.