ESSENTIA HEALTH GRAND RAPIDS CLINIC
NPI 1063942977
Clinic/Center - Multi-Specialty in Grand Rapids, MN
NPI Status: Active since June 13, 2017
Contact Information
1542 GOLF COURSE RD STE 202
GRAND RAPIDS, MN
ZIP 55744
Phone: (218) 999-7000
- Organization
- Clinic/Center
- Multi-Specialty
- CLIA Number: 24D1078962
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 09-09-2027
About ESSENTIA HEALTH GRAND RAPIDS CLINIC
This page provides the complete NPI Profile along with additional information for Essentia Health Grand Rapids Clinic, a provider established in Grand Rapids, Minnesota operating as a Clinic/center, focusing in multi-specialty . The healthcare provider is registered in the NPI registry with number 1063942977 assigned on June 2017. The practitioner's primary taxonomy code is 261QM1300X. The provider is registered as an organization and their NPI record was last updated 4 years ago. The provider's is doing business as Essentia Health Grand Rapids Clinic. The authorized official of this NPI record is Marsha Green (Coo)
- NPI
- 1063942977
- Provider Legal Name
- DEER RIVER HEALTHCARE CENTER INC
- Other Organization Name
- ESSENTIA HEALTH GRAND RAPIDS CLINIC
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 1542 GOLF COURSE RD STE 202 GRAND RAPIDS, MN 55744
- Location Phone
- (218) 999-7000
- Mailing Address
- 1542 GOLF COURSE RD STE 202 GRAND RAPIDS, MN 55744
- Mailing Phone
- (218) 999-7000
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- Yes
- Enumeration Date
- 06-13-2017
- Last Update Date
- 07-21-2022
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Clinic/Center Multi-Specialty
- Taxonomy Code
- 261QM1300X
- Type
- Ambulatory Health Care Facilities
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 24D1078962
- Facility Type
- Physician Office
- Certificate Effective Date
- September 10, 2025
- Certificate Expiration Date
- September 09, 2027
- Laboratory Director
- DR. BENJAMIN R. KOCH
- Certificate Type
- Certificate of Accreditation
- Certificate Type Description
- This is a CLIA certificate is issued to Essentia Health Grand Rapids Clinic on the basis of the laboratory's accreditation by an accreditation organization approved by CMS. This type of certificate is issued to a laboratories tha perform nonwaived (moderate and/or high complexity) testing.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1063942977, we treat the final digit (7) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 63. The final step is to find the difference between that total and the next multiple of ten (70 - 63 = 7).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 63 is 70. The difference is the calculated check digit.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1063942977, enumerated as an "organization" on June 13, 2017.
The provider is located at 1542 GOLF COURSE RD STE 202 GRAND RAPIDS, MN 55744 and the phone number is (218) 999-7000.
Clinic/Center with taxonomy code 261QM1300X and a focus in Multi-Specialty.
