Active NPI
St. Marks Lutheran Home
Doing business as Kenwood Heritage Living
- Skilled Nursing Facility
- Austin, MN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- 328526
- Legal business name
- ST. MARKS LUTHERAN HOME
- Doing business as
- Kenwood Heritage Living
- Practice address
- 400 15TH Ave SW
Austin, MN 55912-3232 - Phone
- (507) 437-4594
- Fax
- (507) 434-7201
- NPI assigned
- Mar 28, 2006
- Last updated
- Oct 3, 2025
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Paula Kay Rocheleau
- Title
- Authorized Agent
- Phone
- (320) 302-0192
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Assisted Living Facility | 310400000X | 329304 | MN | |
| Skilled Nursing Facility | 314000000X | 328526 | MN | Primary |
Addresses
Primary practice location
400 15TH Ave SW
Austin, MN 55912-3232
Mailing address
400 15TH Ave SW
Austin, MN 55912-3232
Phone (507) 437-4594
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 055842700 | Medicaid | MN |
Other names 1
- Kenwood Heritage Living
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040520001306 | MN | Part A Provider - Skilled Nursing Facility | 7810988573 | Practice locations: Austin, MN |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1093776395. Details of each certification follow.
Skilled nursing facility certification: CCN 245369
- Legal name
- ST MARKS LUTHERAN HOME
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Dec 1, 1986
- Last certification
- Apr 3, 2025
- Beds
- 45
- Ownership / control type
- Nonprofit Corporation
- Organization structure
- Corporation
- Incorporated
- Aug 13, 1958 in MN
- Enrollment address
- 400 15TH Ave SW
Austin, MN 55912-3232 - Nursing home name
- ST MARKS LIVING
Care Compare: Nursing home
Medicare Care Compare- Listed as
- St Marks Living
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- Non profit - Corporation
- Certified
- Dec 1, 1986
- Medicare certification status
- Active
- Certified beds
- 45
- Penalties (3 years)
- 3
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 24D0884163 | St Marks Lutheran Home | Certificate of waiver | Mar 25, 2028 |
National Provider Directory
National Provider DirectoryMember of 1
Organizations this organization is a member of, according to the National Provider Directory.
Locations
400 15th Ave SW
Austin, MN 55912
Phone (507) 437-4594
Ownership & related parties
All disclosed owners & managing parties 16
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Craig Gary Ritter | Operational/Managerial Control | Jun 1, 2024 | |
| Adp of the SNF | Jun 1, 2024 | ||
| Paula K Rocheleau | Operational/Managerial Control | Jun 1, 2024 | |
| Adp of the SNF | Jun 1, 2024 | ||
| Emily Brandenburg | Managing Control - Governing Body | Nov 1, 2025 | |
| John Jr. Gray | Managing Control - Governing Body | Jun 1, 2024 | |
| Connie Simonson | Managing Control - Governing Body | Jun 1, 2021 | |
| Gayle Gullickson | Managing Control - Governing Body | Jun 1, 2024 | |
| James Braaten | Managing Control - Governing Body | Mar 18, 2019 | |
| Megan Alvarado | Operational/Managerial Control | Nov 11, 2024 | |
| Adp of the SNF | Nov 11, 2024 | ||
| Jennifer Marie Langbehn | Operational/Managerial Control | Jun 1, 2024 | |
| Adp of the SNF | Jun 1, 2024 | ||
| Crystal Ellefson | Operational/Managerial Control | Jun 1, 2024 | |
| Adp of the SNF | Jun 1, 2024 | ||
| Nancy Donahue | Managing Control - Governing Body | Jun 1, 2021 | |
| Duane Dahlback | Managing Control - Governing Body | Jun 1, 2024 | |
| Kimberly M Rocheleau | Operational/Managerial Control | Jun 1, 2024 | |
| Adp of the SNF | Jun 1, 2024 | ||
| Partners Senior Living Options LLC | Operational/Managerial Control | Jun 1, 2024 | |
| Harlan Nelson | Corporate Director | Jun 1, 2024 | 10% |
| Managing Control - Governing Body | Jun 1, 2024 | ||
| Bradley R Johnson | Corporate Officer | Mar 17, 2008 | |
| Managing Control - Governing Body | Mar 17, 2008 |
Owners & managing parties with NPI records 1
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
- Family Medicine Physician
- Saint James, MN
- NPI 1184608671
Adp of the SNF, Operational/Managerial Control
Facilities with the same owner 4
Facilities that share an organizational owner with 5% or greater ownership or operational control.
-
dba Horizon Health Home Care
- Home Health Agency
- Pierz, MN
- NPI 1023082427
Partners Senior Living Options LLC
-
- Community Based Hospice Care Agency
- Pierz, MN
- NPI 1083959027
Partners Senior Living Options LLC
-
- Skilled Nursing Facility
- Carlton, MN
- NPI 1134125644
Partners Senior Living Options LLC
-
- Skilled Nursing Facility
- Pierz, MN
- NPI 1376656512
Partners Senior Living Options LLC
Practitioners & affiliated clinicians
Practitioners 1
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.
-
- Family Medicine Physician
- Saint James, MN
- NPI 1184608671
Affiliated clinicians 1
Clinicians who list this facility as an affiliation in Medicare Care Compare.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1143504000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1759449600000",
"number": "1093776395",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "400 15TH AVE SW",
"city": "AUSTIN",
"state": "MN",
"postal_code": "559123232",
"telephone_number": "507-437-4594",
"fax_number": "507-434-7201"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "400 15TH AVE SW",
"city": "AUSTIN",
"state": "MN",
"postal_code": "559123232",
"telephone_number": "507-437-4594",
"fax_number": "507-434-7201"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ST. MARKS LUTHERAN HOME",
"organizational_subpart": "NO",
"enumeration_date": "2006-03-28",
"last_updated": "2025-10-03",
"certification_date": "2025-10-03",
"status": "A",
"authorized_official_last_name": "ROCHELEAU",
"authorized_official_first_name": "PAULA",
"authorized_official_middle_name": "KAY",
"authorized_official_title_or_position": "AUTHORIZED AGENT",
"authorized_official_telephone_number": "320-302-0192"
},
"taxonomies": [
{
"code": "310400000X",
"taxonomy_group": "",
"desc": "Assisted Living Facility",
"state": "MN",
"license": "329304",
"primary": false
},
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "MN",
"license": "328526",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "055842700",
"state": "MN"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Kenwood Heritage Living",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Kenwood Heritage Living",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Austin, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 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.