NPIMap

Organization Active NPI

Park Nicollet Methodist Hospital

  • Community Based Hospice Care Agency
  • St Louis Park, MN
National Provider Identifier
1467403444
Registry record updated Aug 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
License
329540 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
Community Based Hospice Care Agency 251G00000X 329540 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
Phone (952) 883-7469

Other names 1

  • Park Nicollet Methodist Hospital Hospice Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080606000389 MN Part A Provider - Hospice 7315840063 Practice locations: Hopkins, MN; St Louis Park, MN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1467403444. Details of each certification follow.

Hospice certification: CCN 241512

Legal name
PARK NICOLLET METHODIST HOSPITAL
Certification status
Active
Provider type (POS)
Hospice
Participating since
Sep 14, 1987
Last certification
Mar 8, 2018
Ownership / control type
Non-Profit - Private
Organization structure
CorporationNon-profit
Incorporated
Jan 1, 1893 in MN
Enrollment address
6500 Excelsior Blvd
St Louis Park, MN 55426-4702

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: Hospice

Medicare Care Compare
Listed as
Park Nicollet Methodist HospitalCCN 241512 · All quality measures
Ownership
Non-Profit
Certified
Sep 14, 1987
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Tax ID family
Methodist Hosp Purc TST12 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

4916 Excelsior Blvd
St Louis Park, MN 55416
Phone (952) 993-0770

Ownership & related parties

All disclosed owners & managing parties 21

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 DirectorDirector 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, Chain home office 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 OfficerVP, Chief Financial Officer Senior Jun 10, 2026
Lisa Bjorkman Individual W-2 Managing EmployeeAd; Jul 27, 2015
Mary Grove Individual Corporate Director Mar 19, 2025

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 134

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

View all 134

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": "1467403444",
    "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",
            "telephone_number": "952-883-7469"
        },
        {
            "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": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "MN",
            "license": "329540",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Park Nicollet Methodist Hospital Hospice",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Park Nicollet Methodist Hospital Hospice",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in St Louis Park, MN

Sources for this page

Verify at the official NPI Registry.