Wayzata Bay Senior Housing, Inc.
Organization Active NPI Skilled Nursing Facility · Wayzata, MN
NPI 1386083160 · NPPES record last updated Aug 26, 2026
Key facts
- NPI
- 1386083160
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- Legal business name
- WAYZATA BAY SENIOR HOUSING, INC.
- Practice address
- 100 Promenade Ave
Wayzata, MN 55391-4542 - Phone
- (952) 249-2500
- Fax
- (952) 249-2501
- NPI assigned
- Jun 14, 2013
- Organization subpart
- No
Authorized official
- Name
- Jon Tranby
- Title
- Director
- Phone
- (651) 631-6102
Owners & managing parties with NPI records 2
-
John W Mielke, M.D.
Member of 1
Facilities with the same owner 22
Affiliated clinicians 2
-
David M Ross, MD
-
Susan Grace Rossi, M.D.
Medicare Care Compare: Nursing home
- Listed as
- Folkestone
- Overall star rating
- ★★★★★ 5 of 5
- Health inspections
- ★★★★☆ 4 of 5
- Staffing
- ★★★★★ 5 of 5
- Quality measures
- ★★★★☆ 4 of 5
- Type
- Medicare
- Ownership
- Non profit - Corporation
- Certified
- Jun 6, 2014
- Medicare certification status
- Active
- Certified beds
- 30 · 27.5 residents per day on average
- Chain
- Presbyterian Homes & Services
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 24D2059564 | Wayzata Bay Senior Housing Inc | Certificate of waiver | May 23, 2027 |
| 24D2193436 | Wayzata Bay Senior Housing | Certificate of waiver | Sep 21, 2026 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
Skilled nursing facility certification: CCN 245621
- Legal name
- WAYZATA BAY SENIOR HOUSING INC
- Doing business as
- FOLKESTONE
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF (Medicare) only
- Participating since
- Jun 6, 2014
- Last certification
- Oct 17, 2024
- Beds
- 30
- Ownership / control type
- Nonprofit Corporation
- Multi-facility organization
- Presbyterian Homes and Services
- Organization structure
- Corporation · Non-profit
- Incorporated
- Jul 30, 2007 in MN
- Enrollment address
- 100 Promenade Ave
Wayzata, MN 55391-4555 - Nursing home name
- FOLKESTONE
- Affiliated entity
- PRESBYTERIAN HOMES & SERVICES
All disclosed owners & managing parties 10
| Name | Role | Since | Share |
|---|---|---|---|
| John W Mielke |
Operational/Managerial Control | Aug 29, 2019 | |
| Adp of the SNF | Apr 14, 2025 | ||
| Computershare Corporate Trust Company, NA |
5% Or Greater Mortgage Interest | Nov 1, 2021 | 67% |
| 5% Or Greater Security Interest | Nov 1, 2021 | 67% | |
| Adp of the SNF | Apr 14, 2025 | ||
| Mark T Meyer |
Corporate Officer |
Jul 30, 2007 | 50% |
| Operational/Managerial Control | Mar 11, 2011 | ||
| Adp of the SNF | Mar 11, 2011 | ||
| Mark a Pederson |
Corporate Director |
Jan 1, 2023 | 33% |
| Jonathan David Fletcher |
Corporate Officer |
Feb 1, 2025 | 50% |
| Corporate Director |
Feb 1, 2025 | 33% | |
| Operational/Managerial Control | Feb 1, 2005 | ||
| Adp of the SNF | Feb 1, 2025 | ||
| PHS Management, LLC |
Operational/Managerial Control | May 30, 2012 | 100% |
| Adp of the SNF | Jul 17, 2025 | ||
| Jacob D Brehmer |
Operational/Managerial Control | Jan 23, 2023 | |
| Adp of the SNF | Apr 14, 2025 | ||
| Heidi a Peterson |
Corporate Director |
Jan 1, 2023 | 33% |
| Operational/Managerial Control | Jan 1, 2023 | ||
| Adp of the SNF | Jan 1, 2023 | ||
| Presbyterian Homes Housing and Assisted Living, Inc. |
5% Or Greater Direct Ownership Interest | May 3, 2012 | 100% |
| Presbyterian Homes and Services |
5% Or Greater Direct Ownership Interest | May 3, 2012 | 100% |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20130813000144 | MN | Part a Provider - Skilled Nursing Facility | 9133361694 | Practice locations: Wayzata, MN |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | Yes |
Addresses
Primary practice location
100 Promenade Ave
Wayzata, MN 55391-4542
Mailing address
2845 Hamline Ave N
Roseville, MN 55113-7127
Phone (651) 631-6432
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| NH1024 | Other | MN | UCARE |
Other names
- Folkestone
Other providers in Wayzata, MN
- Hannah Grace Walsh
- Warby Parker Inc.
- Jamie Warren
- Nannette L Washko
- Elizabeth Brink Watts
- Wayzata Chiropractic Clinic
- Wayzata Dental, LTD.
- Wayzata Endodontics PA
- Wayzata Endodontics, P.a.
- Wayzata Surgery Center
All providers in Wayzata, MN · Skilled Nursing Facility in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 26, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.