Caringedge Healthcare of Hermantown LLC

Organization Active NPI Home Health Agency · Hermantown, MN

NPI 1679078604 · NPPES record last updated Nov 18, 2021

Key facts

NPI
1679078604
Entity type
Organization (NPI type 2)
Primary specialty
Home Health Agency 251E00000X
Legal business name
CARINGEDGE HEALTHCARE OF HERMANTOWN LLC
Practice address
4195 Westberg Rd
Hermantown, MN 55811-2950
Phone
(218) 216-7243
NPI assigned
Mar 30, 2018
Organization subpart
No

Authorized official

Name
Angela Hilleshiem, RN
Title
President
Phone
(208) 473-2717

Facilities with the same owner 8

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

Affiliated clinicians 6

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

Medicare Care Compare: Home health agency

Listed as
Caringedge Healthcare of Hermantown LLC CCN 248157
Overall star rating
★★★☆☆ 2.5 of 5
Ownership
Proprietary
Certified
Apr 30, 2020
Medicare certification status
Active (Provider of Services file)
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

Source: Medicare Care Compare.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MN

Home health agency certification: CCN 248157

Legal name
CARINGEDGE HEALTHCARE OF HERMANTOWN LLC
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Apr 30, 2020
Last certification
Apr 30, 2020
Ownership / control type
Proprietary
Organization structure
LLC · Proprietary
Incorporated
Feb 7, 2017 in MN
Enrollment address
4195 Westberg Rd
Hermantown, MN 55811-2950
HHA Branch

All disclosed owners & managing parties 5

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

NameRoleSinceShare
Angela Hilleshiem
Individual
5% Or Greater Indirect Ownership Interest Dec 31, 2025 5%
Philip Gisi
Individual
5% Or Greater Indirect Ownership Interest Dec 31, 2025 95%
Jill Wilson
Individual
Operational/Managerial Control
President
Nov 1, 2025 100%
Heidi Williams
Individual
W-2 Managing Employee Nov 1, 2025
Edgewood Op Co LLC
Organization · Grand Forks, ND
LLC, Owned by another organization or individual
5% Or Greater Direct Ownership Interest Dec 31, 2025 100%

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20181016003760 MN Part a Provider - Home Health Agency 2961754122 Practice locations: Hermantown, MN

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Yes

Addresses

Primary practice location

4195 Westberg Rd
Hermantown, MN 55811-2950

Mailing address

322 Demers Ave
Grand Forks, ND 58201-4754
Phone (701) 738-2000

Other providers in Hermantown, MN

All providers in Hermantown, MN · Home Health Agency in Minnesota

Sources for this page

Verify at the official NPI Registry.