Vssa Boutwells Landing, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

359577 Issued in MN

Legal business name

VSSA BOUTWELLS LANDING, LLC

Practice address

5600 Norwich Pkwy
Oak Park Heights, MN 55082-6482

Phone

(651) 430-7202

Fax

(651) 430-7201

NPI assigned

Mar 12, 2014

Organization subpart

No

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

Authorized official

Name

Jonathan David Tranby

Title

Payer Relations Director

Phone

(651) 631-6102

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• BOUTWELLS LANDING Other name

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

{
    "created_epoch": "1394582400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788393600000",
    "number": "1518383744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2845 HAMLINE AVE N",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "55113",
            "telephone_number": "651-631-6102",
            "fax_number": "651-746-2752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5600 NORWICH PKWY",
            "city": "OAK PARK HEIGHTS",
            "state": "MN",
            "postal_code": "550826482",
            "telephone_number": "651-430-7202",
            "fax_number": "651-430-7201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VSSA BOUTWELLS LANDING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-12",
        "last_updated": "2026-09-03",
        "status": "A",
        "authorized_official_last_name": "TRANBY",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "PAYER RELATIONS DIRECTOR",
        "authorized_official_telephone_number": "651-631-6102"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "MN",
            "license": "359577",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UMPI",
            "identifier": "A926608200",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Boutwells Landing",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "BOUTWELLS LANDING",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Assisted Living Facility in Oak Park Heights, MN
• Providers in Oak Park Heights, MN by specialty
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.