NPIMap

Organization Active NPI

Jones Harrison Residence Corporation

  • Skilled Nursing Facility
  • Minneapolis, MN
National Provider Identifier
1699762195
Registry record updated Jun 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
328173 Issued in MN
Legal business name
JONES HARRISON RESIDENCE CORPORATION
Practice address
3700 Cedar Lake Ave
Minneapolis, MN 55416-4240
Phone
(612) 920-2030
Fax
(612) 920-2824
NPI assigned
Sep 30, 2005
Last updated
Jun 2, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2022

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

Authorized official

Name
Annette Greely
Title
President/Ceo
Phone
(612) 920-2030

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 329866 MN
Assisted Living Facility 310400000X L14827307 MN
Skilled Nursing Facility 314000000X 328173 MN Primary

Addresses

Primary practice location

3700 Cedar Lake Ave
Minneapolis, MN 55416-4240

Mailing address

3700 Cedar Lake Ave
Minneapolis, MN 55416-4240
Phone (612) 920-2030

Other identifiers 3

IdentifierTypeStateIssuer
461242600MedicaidMN
7122738OtherMEDICA
9626TOOtherBCBS

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address agreely@jones-harrison.org
Direct Messaging Address agreely@jones-harrison.org
Direct Messaging Address crempfer@jones-harrison.org Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060317000544 MN Part A Provider - Skilled Nursing Facility 4486661394 Practice locations: Minneapolis, MN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1699762195. Details of each certification follow.

Skilled nursing facility certification: CCN 245460

Legal name
JONES HARRISON RESIDENCE CORPORATION
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Apr 1, 1987
Last certification
Nov 14, 2024
Beds
120
Ownership / control type
Nonprofit Corporation
Organization structure
CorporationNon-profit
Incorporated
Oct 1, 1928 in MN
Enrollment address
3700 Cedar Lake Ave
Minneapolis, MN 55416-4240
Nursing home name
JONES HARRISON RESIDENCE
Affiliated entity
EBENEZER SENIOR LIVING

Care Compare: Nursing home

Medicare Care Compare
Listed as
Jones Harrison ResidenceCCN 245460 · All quality measures
Overall star rating
3 of 5
Health inspections
2 of 5
Staffing
5 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
Non profit - Corporation
Certified
Apr 1, 1987
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
120107.9 residents per day on average
Chain
Ebenezer Senior Living6 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

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
24D1028394Jones Harrison3700 Cedar Lake Avenue, Minneapolis, MN 55416Certificate of waiverJul 22, 2028

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 13

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

NameRoleSinceShare
Leah Stich Individual Corporate DirectorBoard Member Jul 1, 2023
Managing Control - Governing Body Jul 1, 2023
Marcia Diracles Individual Corporate DirectorBoard Member Jul 1, 2023
Managing Control - Governing Body Jul 1, 2023
Yasser Chebli Individual Operational/Managerial Control Oct 1, 2023
Adp of the SNF Apr 21, 2025
Taylor Harwood Individual Corporate DirectorBoard Member Jul 1, 2023
Managing Control - Governing Body Jul 1, 2023
Elizabeth a Kilburg Individual Corporate DirectorBoard Member Jul 1, 2023
Managing Control - Governing Body Jul 1, 2023
Todd Willett Individual Corporate OfficerChief Financial Officer Jul 1, 2023
Ebenezer Management Services Inc Organization, Edina, MN Corporation, Management services company, For-profit Operational/Managerial Control Jul 1, 2023 100%
Adp of the SNF Jan 30, 2025
Jeffrey Kimpton Individual Corporate DirectorBoard Member Jul 1, 2023
Managing Control - Governing Body Jul 1, 2023
Mackenzie Christopher Individual Operational/Managerial Control Aug 6, 2018
Adp of the SNF Apr 21, 2025
Michael Olafson Individual Corporate DirectorBoard Chair & Secretary Jul 1, 2023
Managing Control - Governing Body Jul 1, 2023
Martha Dimick Individual Corporate DirectorBoard Member Jul 1, 2023
Managing Control - Governing Body Jul 1, 2023
Mary Thorpe Individual Corporate OfficerBoard Member Jul 1, 2023
Managing Control - Governing Body Jul 1, 2023
Brittany Bell Individual Operational/Managerial Control Jul 1, 2023

Owners & managing parties with NPI records 2

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

Facilities with the same owner 7

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

Practitioners & affiliated clinicians

Practitioners 2

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": "1128038400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1654128000000",
    "number": "1699762195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3700 CEDAR LAKE AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554164240",
            "telephone_number": "612-920-2030",
            "fax_number": "612-920-2824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 CEDAR LAKE AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554164240",
            "telephone_number": "612-920-2030",
            "fax_number": "612-920-2824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JONES HARRISON RESIDENCE CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-30",
        "last_updated": "2022-06-02",
        "certification_date": "2022-06-02",
        "status": "A",
        "authorized_official_last_name": "GREELY",
        "authorized_official_first_name": "ANNETTE",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "612-920-2030"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "MN",
            "license": "329866",
            "primary": false
        },
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "MN",
            "license": "L14827307",
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MN",
            "license": "328173",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "461242600",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "7122738",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "9626TO",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "agreely@jones-harrison.org",
            "affiliation": "N",
            "address_1": "3700 Cedar Lake Ave",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554164240",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "agreely@jones-harrison.org",
            "affiliation": "N",
            "address_1": "3700 Cedar Lake Ave",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554164240",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "crempfer@jones-harrison.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3700 Cedar Lake Ave",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554164240",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.