NPIMap

Organization Active NPI

Presbyterian Homes and Services

Doing business as Presbyterian Home Care

  • Home Health Agency
  • Roseville, MN
National Provider Identifier
1881618544
Registry record updated Nov 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
02133 Issued in MN
Legal business name
PRESBYTERIAN HOMES AND SERVICES
Doing business as
Presbyterian Home Care
Practice address
2845 Hamline Ave S
Roseville, MN 55113
Phone
(651) 746-8200
Fax
(651) 746-2787
NPI assigned
Jul 27, 2006
Last updated
Nov 3, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2020

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

Authorized official

Name
Ms. Kristin Stewart
Title
Home Care Director
Phone
(651) 746-8200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 02133 MN Primary

Addresses

Primary practice location

2845 Hamline Ave S
Roseville, MN 55113

Mailing address

2845 Hamline Ave S
Roseville, MN 55113
Phone (651) 746-8200

Other identifiers 1

IdentifierTypeStateIssuer
163015600MedicaidMN

Other names 1

  • Presbyterian Home Care Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110321000508 MN Part A Provider - Home Health Agency 9638087091 Practice locations: Roseville, MN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1881618544. Details of each certification follow.

Home health agency certification: CCN 247087

Legal name
PRESBYTERIAN HOMES AND SERVICES
Doing business as
PRESBYTERIAN HOMES HOMECARE
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Mar 15, 1978
Last certification
Mar 27, 2019
Ownership / control type
Non-Profit
Organization structure
LLCNon-profit
Incorporated
Oct 27, 1950 in MN
Enrollment address
2845 Hamline Ave N
Roseville, MN 55113-7127

Care Compare: Home health agency

Medicare Care Compare
Listed as
Presbyterian Homes Home CareCCN 247087 · All quality measures
Overall star rating
3.5 of 5
Ownership
Non-Profit
Certified
Mar 15, 1978
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
24D0908191Presbyterian Home Care2845 Hamline Ave N, Roseville, MN 55113Certificate of waiverOct 30, 2027

National Provider Directory

National Provider Directory
Tax ID family
Presbyterian Homes and Services2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Member organizations 18

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

View all 18

Ownership & related parties

All disclosed owners & managing parties 14

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

NameRoleSinceShare
Theodore Chien Individual Corporate Director Apr 7, 2011
Molly M Lagermeier Individual Corporate Director Jan 1, 2021
Mark T Meyer Individual Corporate OfficerCfo Jan 18, 2017
John Jay Coughlan Individual Corporate Director Jan 1, 2021
Laura J McKnight Individual Corporate Director Jan 1, 2022
Daniel a Lindh Individual W-2 Managing Employee Apr 7, 2011
Paula Jean Norbom Individual Corporate Director Jan 1, 2020
PHS Management, LLC Organization, Roseville, MN LLC Operational/Managerial Control Mar 11, 2011
James Bernard Green Individual Corporate Director Jan 1, 2016
Jeffrey Kenneth Rageth Individual Corporate Director Jan 1, 2018
Bradford Hewitt Individual Corporate Director Jan 1, 2021
Sheryl Amelia Ramstad Individual Corporate Director Jan 1, 2015
John Alan Clymer Individual Corporate Director Jan 1, 2013
Janet Beth Sommers Individual Corporate Director Jan 1, 2022

All facility ownership & control disclosures 11

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

FacilityTypeRoleSince
Mill PondAnkeny, IA, CCN 165261 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Mar 11, 2011
FlagstoneEden Prairie, MN, CCN 245312 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Sep 1, 2021
Gracepointe Crossing WestCambridge, MN, CCN 245432 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Mar 11, 2011
Presbyterian Homes Bloomington Care Center, IncBloomington, MN, CCN 245556A Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Dec 26, 1996
Langton ShoresSaint Paul, MN, CCN 245389 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2020
Johanna ShoresArden Hills, MN, CCN 245424 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Apr 1, 2020
Waverly GardensNorth Oaks, MN, CCN 245613 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Mar 17, 2020
Carondelet Village Care CenterSaint Paul, MN, CCN 245617 Skilled nursing facility 5% Or Greater Indirect Ownership Interest (50%) Apr 14, 2010
FolkestoneWayzata, MN, CCN 245621 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) May 3, 2012
Norris SquareCottage Grove, MN, CCN 245637 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Jul 25, 2017
Mount Carmel BluffsDubuque, IA, CCN 165792 Skilled nursing facility 5% Or Greater Direct Ownership Interest (50%) Aug 31, 2021

Owned or controlled facilities with NPI records 11

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

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Affiliated clinicians 39

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

View all 39

NPI Registry JSON

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1604361600000",
    "number": "1881618544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2845 HAMLINE AVE S",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "55113",
            "telephone_number": "651-746-8200",
            "fax_number": "651-746-2787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2845 HAMLINE AVE S",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "55113",
            "telephone_number": "651-746-8200",
            "fax_number": "651-746-2787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRESBYTERIAN HOMES AND SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-27",
        "last_updated": "2020-11-03",
        "certification_date": "2020-11-03",
        "status": "A",
        "authorized_official_last_name": "STEWART",
        "authorized_official_first_name": "KRISTIN",
        "authorized_official_title_or_position": "HOME CARE DIRECTOR",
        "authorized_official_telephone_number": "651-746-8200",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "MN",
            "license": "02133",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "163015600",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Presbyterian Home Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Presbyterian Home Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Roseville, MN

Sources for this page

Verify at the official NPI Registry.