NPIMap

Organization Active NPI

Caringedge Healthcare of Minot LLC

  • Home Health Agency
  • Minot, ND
National Provider Identifier
1669907291
Registry record updated Dec 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
CARINGEDGE HEALTHCARE OF MINOT LLC
Practice address
800 16TH Ave SE
Minot, ND 58701-6781
Phone
(888) 223-4287
NPI assigned
Apr 20, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 26, 2023

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

Authorized official

Name
Jennifer Lyn Davis
Title
Vice President of Health Services
Phone
(208) 473-2717

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

800 16TH Ave SE
Minot, ND 58701-6781

Mailing address

800 16TH Ave SE
Minot, ND 58701-6781
Phone (888) 223-4287

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180220000242 ND Part A Provider - Home Health Agency 9931465705 Practice locations: Bismarck, ND; Minot, ND

Home health agency certification: CCN 357305

Legal name
CARINGEDGE HEALTHCARE OF MINOT LLC
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Aug 22, 2018
Last certification
Aug 22, 2018
Ownership / control type
Proprietary
Organization structure
LLCProprietary
Incorporated
Feb 7, 2017 in ND
Enrollment address
800 16TH Ave SE
Minot, ND 58701-6781

Care Compare: Home health agency

Medicare Care Compare
Listed as
Caringedge Healthcare of MinotCCN 357305
Overall star rating
3 of 5
Ownership
Proprietary
Certified
Aug 22, 2018
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
35D2134584Caringedge Healthcare of Minot LLC800 16TH Ave SE, Minot, ND 58701Certificate of waiverAug 6, 2027

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 7

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

NameRoleSinceShare
Janessa Vogel Individual W-2 Managing EmployeeAdministrator Sep 1, 2023
Angela Hilleshiem Individual 5% Or Greater Direct Ownership InterestPresident Jan 1, 2018 5%
Michael Philip Gisi Individual 5% Or Greater Indirect Ownership Interest Feb 17, 2017 11.4%
Emily Marie Gisi Individual 5% Or Greater Indirect Ownership Interest Jul 7, 2017 11.4%
Philip Gisi Individual 5% Or Greater Indirect Ownership InterestCeo Apr 1, 2017 37.1%
Corporate DirectorBoard Member Feb 7, 2017
Jill Wilson Individual Operational/Managerial ControlPresident Nov 1, 2025 100%
Edgewood Op Co LLC Organization, Grand Forks, ND LLC 5% Or Greater Direct Ownership Interest Feb 7, 2017 95%

Facilities with the same owner 8

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

Practitioners & affiliated clinicians

Affiliated clinicians 35

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

View all 35

NPI Registry JSON

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

{
    "created_epoch": "1492646400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1703548800000",
    "number": "1669907291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 16TH AVE SE",
            "city": "MINOT",
            "state": "ND",
            "postal_code": "587016781",
            "telephone_number": "888-223-4287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 16TH AVE SE",
            "city": "MINOT",
            "state": "ND",
            "postal_code": "587016781",
            "telephone_number": "888-223-4287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARINGEDGE HEALTHCARE OF MINOT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-20",
        "last_updated": "2023-12-26",
        "certification_date": "2023-12-26",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "LYN",
        "authorized_official_title_or_position": "VICE PRESIDENT OF HEALTH SERVICES",
        "authorized_official_telephone_number": "208-473-2717"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minot, ND

Sources for this page

Verify at the official NPI Registry.