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GRAND ITASCA CLINIC AND HOSPITAL
NPI 1023326980
Non-Pharmacy Dispensing Site in Grand Rapids, MN

Active since September 14, 2010CLIA Certified · 2 labs
1601 GOLF COURSE RD, GRAND RAPIDS, MN 55744(218) 326-7503 Get Directions Write a Review

NPPES record last updated: September 14, 2010. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Grand Itasca Clinic And Hospital NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GRAND ITASCA CLINIC AND HOSPITAL (NPI 1023326980) is a healthcare organization registered as a non-pharmacy dispensing site in Grand Rapids, Minnesota and active in the NPI registry since September 2010. The organization holds 2 active CLIA laboratory certificates and lists Melissa Walters, Director Of Pharmacy, as its authorized official.

NPPES Registry Identity

NPI1023326980
Entity TypeOrganization
Primary Taxonomy332900000X
Legal Business NameGRAND ITASCA CLINIC AND HOSPITAL
Location Address1601 GOLF COURSE RDGrand Rapids, MN 55744-8648
Mailing Address6501 City West PkwyEden Prairie, MN 55344-3248 · (952) 653-2565
Phone(218) 326-7503
Organization SubpartYes
Authorized OfficialMelissa WaltersDirector Of Pharmacy · (952) 653-2565
Enumeration DateSeptember 14, 2010
✔ NPI 1023326980 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNon-Pharmacy Dispensing SiteSuppliers
Taxonomy Code332900000X
Definition
A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.)
1601 GOLF COURSE RD, Grand Rapids, MN 55744
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Anthem Blue Cross and Blue Shield, Antidote Health Plan of Arizona, Inc. and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA 2

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 24D2341698

Grand Itasca Clinic And Hospital - Poc · Grand Rapids, MN
Active · expires Apr 6, 2028
CLIA Number24D2341698
Laboratory TypeHospital
Certificate Effective DateApril 7, 2026
Certificate Expiration DateApril 6, 2028
Laboratory DirectorJack B. Shelton
Laboratory Phone(218) 999-1920
Laboratory LocationGrand Itasca Clinic And Hospital - Poc1601 Golf Course Rd, Grand Rapids, MN 55744
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Accreditation 24D0403710

Grand Itasca Clinic And Hospital · Grand Rapids, MN
Active · expires May 25, 2027
CLIA Number24D0403710
Laboratory TypeHospital
Certificate Effective DateMay 26, 2025
Certificate Expiration DateMay 25, 2027
Laboratory DirectorDr. Jack B. Shelton
Laboratory Phone(218) 999-1920
Laboratory LocationGrand Itasca Clinic And Hospital1601 Golf Course Rd, Grand Rapids, MN 55744
CLIA data matches this NPI record on: Address Name
This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. JESSICA JO DAY NURSE PRACTITIONER
Nurse Practitioner (Family)
1601 GOLF COURSE RD
GRAND RAPIDS, MN 55744
Itasca County (218) 326-3401
EMILEE OLSON
Student in an Organized Health Care Education/Training Program
1601 GOLF COURSE RD
GRAND RAPIDS, MN 55744
Itasca County (218) 326-3401
LINDSEY PERATALO PMHNP
Nurse Practitioner (Psychiatric/Mental Health)
1601 GOLF COURSE RD
GRAND RAPIDS, MN 55744
Itasca County (218) 360-3401
DR. PATRICIA C. CARLIN-JANSSEN MD
Family Medicine
1601 GOLF COURSE RD
GRAND RAPIDS, MN 55744
Itasca County (218) 326-5000
BOBBI JEAN OLSON CNP
Nurse Practitioner (Family)
1601 GOLF COURSE RD
GRAND RAPIDS, MN 55744
Itasca County (218) 326-3401
KALIE R DRAZENOVICH CNP
Nurse Practitioner (Family)
1601 GOLF COURSE RD
GRAND RAPIDS, MN 55744
Itasca County (612) 244-5325
CAITLIN LEIGH MEYERS PA-C
Physician Assistant
1601 GOLF COURSE RD
GRAND RAPIDS, MN 55744
Itasca County (218) 326-3401
DANIEL JOSEPH MCGUIRE MD
Surgery
1601 GOLF COURSE RD
GRAND RAPIDS, MN 55744
Itasca County (218) 326-3401

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Grand Itasca Clinic And Hospital's NPI number?

The NPI number for Grand Itasca Clinic And Hospital is 1023326980. It was assigned to this organization in the NPPES registry on September 14, 2010.

Where is Grand Itasca Clinic And Hospital located?

Grand Itasca Clinic And Hospital is located at 1601 Golf Course Rd, Grand Rapids, MN 55744. The listed phone number is (218) 326-7503.

What is Grand Itasca Clinic And Hospital's specialty?

The primary specialty registered for this NPI is Non-Pharmacy Dispensing Site with taxonomy code 332900000X.

Does Grand Itasca Clinic And Hospital hold CLIA laboratory certificates?

Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

What insurance does Grand Itasca Clinic And Hospital accept?

Health plans from Alliant Health Plans, Inc., Anthem Blue Cross and Blue Shield, Antidote Health Plan of Arizona, Inc., Antidote Health Plan of Ohio, Inc. and Avera Health Plans and 19 other insurers list Grand Itasca Clinic And Hospital as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Grand Itasca Clinic And Hospital was last updated on September 14, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.