NPIMap

Organization Active NPI

Presbyterian Home Care Centers Inc

Doing business as Presbyterian Homes of Roseville Care Center

  • Skilled Nursing Facility
  • Roseville, MN
National Provider Identifier
1679597322
Registry record updated Aug 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
PRESBYTERIAN HOME CARE CENTERS INC
Doing business as
Presbyterian Homes of Roseville Care Center
Practice address
1900 County Road D
Roseville, MN 55113
Phone
(651) 631-6200
Fax
(651) 631-6081
NPI assigned
Jul 26, 2006
Last updated
Aug 28, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2026

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

Authorized official

Name
Jon Tranby
Title
Director
Phone
(651) 631-6102

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

1900 County Road D
Roseville, MN 55113

Mailing address

1900 County Road D W
Saint Paul, MN 55112-3503
Phone (651) 631-6432

Other identifiers 4

IdentifierTypeStateIssuer
7100332OtherMEDICA
9756LAOtherBCBS
4671OtherHEALTH PARTNERS
NH0042OtherUCARE

Other names 2

  • Presbyterian Homes of Roseville Care Center Doing business as
  • Langton Shores Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100323000350 MN Part A Provider - Skilled Nursing Facility 9133254691 Practice locations: Saint Paul, MN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1679597322. Details of each certification follow.

Skilled nursing facility certification: CCN 245389

Legal name
PRESBYTERIAN HOME CARE CENTERS INC
Doing business as
LANGTON SHORES
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Dec 1, 1986
Last certification
Nov 21, 2024
Beds
50
Ownership / control type
Nonprofit Corporation
Organization structure
CorporationNon-profit
Incorporated
Dec 6, 1984 in MN
Enrollment address
1900 County Road D W
Saint Paul, MN 55112-3503
Nursing home name
LANGTON SHORES
Affiliated entity
PRESBYTERIAN HOMES & SERVICES

Care Compare: Nursing home

Medicare Care Compare
Listed as
Langton ShoresCCN 245389 · All quality measures
Overall star rating
5 of 5
Health inspections
5 of 5
Staffing
5 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
Non profit - Corporation
Certified
Dec 1, 1986
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
5044.7 residents per day on average
Chain
Presbyterian Homes & Services21 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Member organizations 2

Organizations listed as members of this organization in the National Provider Directory.

Locations

1900 County Road C W
#D
Roseville, MN 55113
Phone (651) 631-6200

1900 County Road D W
Saint Paul, MN 55112
Phone (651) 631-6100

Ownership & related parties

All disclosed owners & managing parties 9

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

NameRoleSinceShare
John W Mielke Individual Operational/Managerial Control Aug 29, 2019
Adp of the SNF Aug 28, 2023
Mark T Meyer Individual Corporate Officer Mar 11, 2011 50%
Operational/Managerial Control Mar 11, 2011
Adp of the SNF Mar 11, 2011
Mark a Pederson Individual Corporate DirectorBoard Member Jan 1, 2023 33%
Operational/Managerial Control Jan 1, 2023
Allison Gagnon Individual Operational/Managerial Control Jun 18, 2024
Adp of the SNF Jun 18, 2024
Jonathan David Fletcher Individual Corporate OfficerPresident & Ceo Feb 1, 2025 50%
Corporate DirectorBoard Member Feb 1, 2025 33%
Operational/Managerial Control Feb 1, 2025
Adp of the SNF Feb 1, 2025
PHS Management, LLC Organization, Roseville, MN LLC, Management services company, Non-profit, Chain home office Operational/Managerial Control Mar 11, 2011 100%
Adp of the SNF Nov 20, 2025
Heidi a Peterson Individual Corporate DirectorBoard Member Feb 1, 2025 33%
Operational/Managerial Control Jan 1, 2023
Adp of the SNF Jan 1, 2023
Associated Bank, National Association Organization, Green Bay, WI Corporation, Financial institution, For-profit 5% Or Greater Mortgage Interest Dec 6, 2018 75%
5% Or Greater Security Interest Dec 6, 2018 75%
Presbyterian Homes and Services Organization, Roseville, MN Corporation, Non-profit 5% Or Greater Direct Ownership Interest Jan 1, 2020 100%

Owners & managing parties with NPI records 2

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

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Harmony River Living CenterHutchinson, MN, CCN 245114 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Aug 1, 2018

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 22

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

View all 22

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

Affiliated clinicians 2

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

NPI Registry JSON

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1787875200000",
    "number": "1679597322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 COUNTY ROAD D W",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551123503",
            "telephone_number": "651-631-6432",
            "fax_number": "651-631-6122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 COUNTY ROAD D",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "55113",
            "telephone_number": "651-631-6200",
            "fax_number": "651-631-6081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRESBYTERIAN HOME CARE CENTERS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-26",
        "last_updated": "2026-08-28",
        "certification_date": "2026-08-28",
        "status": "A",
        "authorized_official_last_name": "TRANBY",
        "authorized_official_first_name": "JON",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "651-631-6102"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "7100332",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "9756LA",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PARTNERS",
            "identifier": "4671",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE",
            "identifier": "NH0042",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Presbyterian Homes of Roseville Care Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Langton Shores",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Roseville, MN

Sources for this page

Verify at the official NPI Registry.