NPIMap

Organization Active NPI

Park Nicollet Methodist Hospital

  • Home Health Agency
  • St Louis Park, MN
National Provider Identifier
1447201421
Registry record updated Aug 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
329934 Issued in MN
Legal business name
PARK NICOLLET METHODIST HOSPITAL
Practice address
6500 Excelsior Blvd
St Louis Park, MN 55426-4702
Phone
(952) 993-6807
Fax
(952) 993-5081
NPI assigned
May 13, 2006
Last updated
Aug 3, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2026

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

Authorized official

Name
Alita Risinger
Title
Sr Vice President, Cfo
Phone
(952) 883-5401

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 329934 MN Primary

Addresses

Primary practice location

6500 Excelsior Blvd
St Louis Park, MN 55426-4702

Mailing address

8170 33Rd Avenue South
Mailstop 21110Q
Bloomington, MN 55425

Other names 1

  • Park Nicollet Methodist Hospital Homecare Services Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080606000369 MN Part A Provider - Home Health Agency 7315840063 Practice locations: St Louis Park, MN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1447201421. Details of each certification follow.

Home health agency certification: CCN 247151

Legal name
PARK NICOLLET METHODIST HOSPITAL
Doing business as
PARK NICOLLET METHODIST HOSPITAL HOMECARE SERVICES
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Dec 1, 1983
Last certification
Jan 4, 2019
Ownership / control type
Proprietary
Organization structure
CorporationNon-profit
Incorporated
Jan 1, 1893 in MN
Enrollment address
4916 Excelsior Blvd
Mailstop 61901D
St Louis Park, MN 55416-3032

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Home health agency

Medicare Care Compare
Listed as
Park Nicollet Methodist Hospital Care SVCSCCN 247151 · All quality measures
Overall star rating
3 of 5
Ownership
Proprietary
Certified
Dec 1, 1983
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

National Provider Directory

National Provider Directory
Tax ID family
Back and Neck Clinic12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

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

Locations

6500 Excelsior Blvd
St Louis Park, MN 55426
Phone (952) 993-3246

Ownership & related parties

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.

NameRoleSinceShare
Craig Larson Individual W-2 Managing Employee Oct 1, 2013
Rae Ann Williams Individual Corporate Director Jan 1, 2018
Robert Ehren Individual Corporate Director Jan 1, 2024
Mark R Sannes Individual Corporate Director Jan 1, 2025
Morris Goodwin Individual Corporate Director Jan 1, 2017
Jason Luhrs Individual Corporate DirectorVP Finance Sep 15, 2021
Park Nicollet Health Services Organization, St Louis Park, MN Non-profit Operational/Managerial Control Feb 5, 2008
Laura Liu Individual Corporate Director Jan 1, 2023
Kathleen a Kelley Individual Corporate Director Jan 1, 2021
Sherri Lynn Broderius Individual Corporate Director Jan 1, 2025
Bradley Wozney Individual Corporate Director Jan 1, 2019
Amelia Hardy Individual Corporate Director Jan 1, 2026
Jerome C Siy Individual Corporate Director Jan 1, 2026
Sharon Pierce Evan Individual Corporate Director Jan 1, 2020
Ana Lee Individual Corporate Director Jan 1, 2022
Paul D Williams Individual Corporate Director Jan 1, 2021
David Lagerstrom Individual Corporate Director Jan 1, 2022
Tonya Van Hee Individual W-2 Managing EmployeeMD; Jun 1, 2026
Alita R Risinger Individual Corporate Director Apr 17, 2026
Lisa Bjorkman Individual W-2 Managing Employee Aug 27, 2019

Owners & managing parties with NPI records 5

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

Facilities with the same owner 6

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

Practitioners & affiliated clinicians

Affiliated clinicians 100

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 100

NPI Registry JSON

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

{
    "created_epoch": "1147478400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1785715200000",
    "number": "1447201421",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8170 33RD AVENUE SOUTH",
            "address_2": "MAILSTOP 21110Q",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "55425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6500 EXCELSIOR BLVD",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554264702",
            "telephone_number": "952-993-6807",
            "fax_number": "952-993-5081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARK NICOLLET METHODIST HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-13",
        "last_updated": "2026-08-03",
        "certification_date": "2026-08-03",
        "status": "A",
        "authorized_official_last_name": "RISINGER",
        "authorized_official_first_name": "ALITA",
        "authorized_official_title_or_position": "SR VICE PRESIDENT, CFO",
        "authorized_official_telephone_number": "952-883-5401"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "MN",
            "license": "329934",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Park Nicollet Methodist Hospital Homecare Services",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Park Nicollet Methodist Hospital Homecare Services",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in St Louis Park, MN

Sources for this page

Verify at the official NPI Registry.