Pediatric Home Respiratory Services LLC

Primary specialty

Nursing Care AgencyTaxonomy code 251J00000X

Legal business name

PEDIATRIC HOME RESPIRATORY SERVICES LLC

Practice address

2800 Cleveland Ave N
Roseville, MN 55113-1126

Phone

(651) 642-1825

Fax

(652) 638-0690

NPI assigned

Nov 15, 2006

Organization subpart

No

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

Authorized official

Name

Cameo Kae Zehnder

Title

Chief Administrative Officer

Phone

(651) 642-1825

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Pediatric Home Service Doing business as

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Home health agency certification: CCN 248149

Legal name

PEDIATRIC HOME RESPIRATORY SERVICES, LLC

Doing business as

PEDIATRIC HOME SERVICE

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Nov 30, 2017

Last certification

Nov 30, 2017

Ownership / control type

Proprietary

Organization structure

LLCProprietary

Incorporated

Dec 13, 1989 in DE

Enrollment address

2800 Cleveland Ave N
Roseville, MN 55113-1126
HHA Branch

Listed as

Pediatric Home ServiceCCN 248149

Ownership

Proprietary

Certified

Nov 30, 2017

Medicare certification status

ActiveFrom the Provider of Services file

Services

Nursing, Medical social

Tax ID family

Pediatric Home Service5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

• Pediatric Home Respiratory Services LLC

  • Home Health Agency
  • Roseville, MN
  • NPI 1144722190
  NPD tax ID
• Pediatric Home Respiratory Services LLC

  • Durable Medical Equipment & Medical Supplies
  • Roseville, MN
  • NPI 1629141213
  NPD tax ID
• Pediatric Home Respiratory Services LLC

  • Community/Behavioral Health Agency
  • Roseville, MN
  • NPI 1790943199
  NPD tax ID
• Pediatric Home Respiratory Services LLC

  • Home Infusion Therapy Pharmacy
  • Roseville, MN
  • NPI 1932266632
  NPD tax ID

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Duke University

  • Surgery Physician
  • Durham, NC
  • NPI 1841222395

  Member Of

  NPD member

All disclosed owners & managing parties 20

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

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

• Duke University

  • Surgery Physician
  • Durham, NC
  • NPI 1841222395

  5% Or Greater Indirect Ownership Interest

  CMS ownership

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Craig Resources LLC

  • Home Health Agency
  • Wichita, KS
  • NPI 1689699837

  5% Or Greater Direct Ownership Interest, Operational/Managerial Control

  CMS ownership

Facilities with the same owner 3

Facilities that share an organizational owner with 5% or greater ownership or operational control.

• Craig Resources LLC

  • Home Health Agency
  • Wichita, KS
  • NPI 1689699837

  Brandywine Private Equity Partners (2016), L.P, Brandywine Private Equity Partners (2018), L.P., Duke University, Gef-Apeb, LP, Gothic Corporation, Intandem Capital Opportunities Fund, LP, Intandem Capital Partners Fund, LP, Itc (PHS) Parallel Fund

  CMS ownership
• Pathways Hospice, LLC

  • Community Based Hospice Care Agency
  • Monroe, GA
  • NPI 1881364750

  Gothic Corporation, Intandem Capital Opportunities Fund, LP, SFT Private Equity LLC (2016)

  CMS ownership
• Providence Care LLC

  • Community Based Hospice Care Agency
  • Rock Hill, SC
  • NPI 1891005104

  Gothic Corporation, Intandem Capital Opportunities Fund, LP, SFT Private Equity LLC (2016)

  CMS ownership

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1769990400000",
    "number": "1285706911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 CLEVELAND AVE N",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551131126",
            "telephone_number": "651-642-1825",
            "fax_number": "652-638-0690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 CLEVELAND AVE N",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551131126",
            "telephone_number": "651-642-1825",
            "fax_number": "652-638-0690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC HOME RESPIRATORY SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-15",
        "last_updated": "2026-02-02",
        "certification_date": "2026-02-02",
        "status": "A",
        "authorized_official_last_name": "ZEHNDER",
        "authorized_official_first_name": "CAMEO",
        "authorized_official_middle_name": "KAE",
        "authorized_official_title_or_position": "CHIEF ADMINISTRATIVE OFFICER",
        "authorized_official_telephone_number": "651-642-1825"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "242121600",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS-MN",
            "identifier": "8Z50PE",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pediatric Home Service",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Pediatric Home Service",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• James Archie Peasley, LMFT
• Julie Anne Peck, RN
• Karen Pedersen
• Samantha R Pederson, DC
• Pediatric Home Respiratory Services LLC
• Pediatric Home Respiratory Services LLC
• Pediatric Home Respiratory Services LLC
• Pediatric Home Respiratory Services LLC
• Karah Lin Pendergrass, LPN
• Ricardo Andres Pepe Antonello

• Nursing Care Agency in Roseville, MN
• Providers in Roseville, MN by specialty
• Nursing Care Agency in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2026; 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.