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ESSENTIA HEALTH GRAND RAPIDS CLINIC
NPI 1063942977
Clinic/Center - Multi-Specialty in Grand Rapids, MN

Active since June 13, 2017CLIA 24D1078962 · Accreditation
1542 GOLF COURSE RD STE 202, GRAND RAPIDS, MN 55744(218) 999-7000 Get Directions Write a Review

NPPES record last updated: July 21, 2022. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Jul 21, 2022, Jun 16, 2018, Jul 10, 2017 and 1 more (4 updates tracked since 2017).

About Essentia Health Grand Rapids Clinic NPPES

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

ESSENTIA HEALTH GRAND RAPIDS CLINIC (NPI 1063942977) is a healthcare organization registered as a multi-specialty in Grand Rapids, Minnesota and active in the NPI registry since June 2017. The organization holds an CLIA Accreditation certificate valid through September 9, 2027 and lists Marsha Green, Coo, as its authorized official.

NPPES Registry Identity

NPI1063942977
Entity TypeOrganization
Primary Taxonomy261QM1300X
Legal Business NameDEER RIVER HEALTHCARE CENTER INC
Location Address1542 GOLF COURSE RD STE 202Grand Rapids, MN 55744-3557
Mailing Address1542 Golf Course Rd Ste 202Grand Rapids, MN 55744-3557 · (218) 999-7000
Phone(218) 999-7000
Organization SubpartYesParent: St. Mary's Duluth Clinic Health System
Authorized OfficialMarsha GreenCoo · (218) 246-4200
Enumeration DateJune 13, 2017
Last NPPES UpdateJuly 21, 20224 updates tracked since enumeration
✔ NPI 1063942977 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Multi-SpecialtyAmbulatory Health Care Facilities
Taxonomy Code261QM1300X
1542 GOLF COURSE RD STE 202, Grand Rapids, MN 55744
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Other Names 2

Doing Business AsEssentia Health Grand Rapids Clinic
Doing Business AsEssentia Health Grand Rapids Specialty Clinic

CLIA Laboratory Certificates CMS CLIA

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 Accreditation 24D1078962

Essentia Health Grand Rapids Clinic · Grand Rapids, MN
Active · expires Sep 9, 2027
CLIA Number24D1078962
Laboratory TypePhysician Office
Certificate Effective DateSeptember 10, 2025
Certificate Expiration DateSeptember 9, 2027
Laboratory DirectorDr. Benjamin R. Koch
Laboratory Phone(218) 322-4882
Laboratory LocationEssentia Health Grand Rapids Clinic1542 Golf Course Rd Suite 204, Grand Rapids, MN 55744
CLIA data matches this NPI record on: 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.

Frequently Asked Questions

What is DEER RIVER HEALTHCARE CENTER INC's NPI number?

The NPI number assigned to this healthcare provider is 1063942977, enumerated as an "organization" on June 13, 2017.

Where is the provider located?

The provider is located at 1542 GOLF COURSE RD STE 202 GRAND RAPIDS, MN 55744 and the phone number is (218) 999-7000.

What is the provider's specialty?

Clinic/Center with taxonomy code 261QM1300X and a focus in Multi-Specialty.