Compassionate Home Care LTD

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

32519 Issued in MN

Legal business name

COMPASSIONATE HOME CARE LTD

Practice address

12950 Fremont Ave Ste 102
Zimmerman, MN 55398-4629

Phone

(763) 238-5215

Fax

(763) 374-7161

NPI assigned

Mar 28, 2017

Last updated

Nov 11, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jan Marie NicodemusNPI 1659886448

Title

Owner

Phone

(763) 238-5215

Specialties & licenses 3

Addresses

Other identifiers 3

Other names 1

• Compassionate Home Care LTD LTD Former legal business name

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1083146344. Details of each certification follow.

• CCN 248165 Home health agency · Active · Details

Home health agency certification: CCN 248165

Legal name

COMPASSIONATE HOME CARE LTD

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Sep 13, 2024

Last certification

Aug 29, 2024

Organization structure

CorporationProprietary

Incorporated

Mar 28, 2017 in MN

Enrollment address

12950 Fremont Ave
Ste 102
Zimmerman, MN 55398-4629
HHA Branch

Listed as

Compassionate Home Care LTDCCN 248165 · All quality measures

Ownership

-

Certified

Sep 13, 2024

Medicare certification status

ActiveFrom the Provider of Services file

Locations

All disclosed owners & managing parties 1

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

Practitioners 3

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.

• Jan Marie Nicodemus

  • Home Health Aide
  • Zimmerman, MN
  • NPI 1659886448

  Case Management

  NPD Authorized official
• Holly Beth Zelenak, REGISTERED NURSE

  • Home Health Registered Nurse
  • Zimmerman, MN
  • NPI 1720933674
  NPD
• Theresa A Beardsley, REGISTERED NURSE

  • Home Health Registered Nurse
  • Zimmerman, MN
  • NPI 1295203446
  NPD (past)

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

{
    "created_epoch": "1490659200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762819200000",
    "number": "1083146344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12950 FREMONT AVE STE 102",
            "city": "ZIMMERMAN",
            "state": "MN",
            "postal_code": "553984629",
            "telephone_number": "763-238-5215",
            "fax_number": "763-374-7161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12950 FREMONT AVE STE 102",
            "city": "ZIMMERMAN",
            "state": "MN",
            "postal_code": "553984629",
            "telephone_number": "763-238-5215",
            "fax_number": "763-374-7161"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "155 Trail Dr",
            "address_purpose": "LOCATION",
            "city": "Ranchester",
            "state": "WY",
            "postal_code": "828395030",
            "country_code": "US",
            "telephone_number": "763-238-5215",
            "fax_number": "763-374-7161",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "COMPASSIONATE HOME CARE LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-28",
        "last_updated": "2025-11-11",
        "certification_date": "2025-11-11",
        "status": "A",
        "authorized_official_last_name": "NICODEMUS",
        "authorized_official_first_name": "JAN",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "763-238-5215"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "MN",
            "license": "32519",
            "primary": true
        },
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": "MN",
            "license": "32519",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HOME HEALTH AGENCY",
            "identifier": "15416",
            "state": "WY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HOME HEALTH AGENCY",
            "identifier": "1083146344",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "248165",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Compassionate Home Care LTD LTD",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Compassionate Home Care LTD LTD",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Home Health Agency in Zimmerman, MN
• Providers in Zimmerman, MN by specialty
• Home Health Agency in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.