PHS-Norfolk Ave LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

PHS-NORFOLK AVE LLC

Practice address

1925 Norfolk Ave
Saint Paul, MN 55116-2575

Phone

(651) 631-6100

Fax

(651) 631-6122

NPI assigned

Mar 4, 2022

Organization subpart

No

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

Authorized official

Name

Jon Tranby

Title

Payer Relations Director

Phone

(651) 631-6102

Specialties & licenses 1

Addresses

Other names 1

• Highland Path Doing business as

Electronic endpoints 1

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

{
    "created_epoch": "1646352000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1787011200000",
    "number": "1750038295",
    "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": "551137127",
            "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": "1925 NORFOLK AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551162575",
            "telephone_number": "651-631-6100",
            "fax_number": "651-631-6122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHS-NORFOLK AVE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-04",
        "last_updated": "2026-08-18",
        "certification_date": "2026-08-18",
        "status": "A",
        "authorized_official_last_name": "TRANBY",
        "authorized_official_first_name": "JON",
        "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": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Hamlap430",
            "affiliation": "N",
            "endpointDescription": "Hamlap430",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "Roseville",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Roseville",
            "address_1": "1925 Norfolk Ave",
            "city": "Saint Paul",
            "state": "MN",
            "country_code": "US",
            "postal_code": "551162575",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Highland Path",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 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.