Organization Active NPI

Homeland Health Specialists Inc

  • Community Health Registered Nurse
  • Minneapolis, MN
National Provider Identifier
1992818231
Registry record updated Jun 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health Registered NurseTaxonomy code 163WC1500X
License
R121223-7 Issued in MN
Legal business name
HOMELAND HEALTH SPECIALISTS INC
Practice address
1621 E Hennepin Ave Ste 230
Minneapolis, MN 55414-2489
Phone
(763) 746-8060
Fax
(763) 746-8063
NPI assigned
Aug 17, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2025

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

Authorized official

Name
Thomas Wisted
Title
President & Ceo
Phone
(847) 894-0774

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Registered NurseGroup: 193400000X SINGLE SPECIALTY GROUP 163WC1500X R121223-7 MN Primary

Addresses

Primary practice location

1621 E Hennepin Ave Ste 230
Minneapolis, MN 55414-2489

Mailing address

1621 E Hennepin Ave Ste 230
Minneapolis, MN 55414-2489
Phone (763) 746-8060

Other identifiers 7

IdentifierTypeStateIssuer
164398OtherMNUCARE
8300115OtherMEDICA
234933100MedicaidMN
4605640OtherMNBCBS OF MN
87361OtherHEALTH PARTNERS
1031834OtherPREFERRED ONE
870000829OtherHUMANA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031231000235 MN Part B Supplier - Mass Immunization (Roster Biller Only) 1850290677 Practice locations: Minneapolis, MN

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
24D1097815Homeland Health Specialists Inc1621 E Hennepin Ave, Ste 230, Minneapolis, MN 55414Certificate of waiverApr 2, 2027

National Provider Directory

National Provider Directory

Locations (25 of 54)

3010 Bemidji Ave N
Bemidji, MN 56601

406 W Washington St
Brainerd, MN 56401

200 S 6th St
Brainerd, MN 56401

6300 Shingle Creek Pkwy
Ste 170
Brooklyn Center, MN 55430

205 1st St S
Buffalo, MN 55313
Phone (763) 682-2244

555 Highway 55 E
Buffalo, MN 55313

630 1st Ave NW
Byron, MN 55920

1001 Highway 95 E
Ste 130A
Cambridge, MN 55008

316 W Lake St
Chisholm, MN 55719
Phone (218) 254-7900

900 Central St E
Detroit Lakes, MN 56501

826 Summit Ave
Detroit Lakes, MN 56501

325 S Lake Ave
Duluth, MN 55802

2304 Mountain Shadow Dr
Duluth, MN 55811

121 Demers Ave
East Grand Forks, MN 56721

800 A Ave
Eveleth, MN 55734

25 4th St NW
Ste 104
Faribault, MN 55021

225 W Lincoln Ave
Fergus Falls, MN 56537
Phone (218) 531-1424

126 2ND St NW
Fosston, MN 56542

113 E Burlingame St
Ghent, MN 56239

606 11th St E
Glencoe, MN 55336

535 E Highway 2
Grand Rapids, MN 55744

207 W 42ND St
Hibbing, MN 55746

608 Fire Monument Rd
Hinckley, MN 55037

3824 SW 93rd St
Hope, MN 56046

225 Shady Ridge Rd NW
Hutchinson, MN 55350
Phone (320) 587-7077

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1155772800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1748995200000",
    "number": "1992818231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1621 E HENNEPIN AVE STE 230",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554142489",
            "telephone_number": "763-746-8060",
            "fax_number": "763-746-8063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1621 E HENNEPIN AVE STE 230",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554142489",
            "telephone_number": "763-746-8060",
            "fax_number": "763-746-8063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOMELAND HEALTH SPECIALISTS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-17",
        "last_updated": "2025-06-04",
        "certification_date": "2025-06-04",
        "status": "A",
        "authorized_official_last_name": "WISTED",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "847-894-0774"
    },
    "taxonomies": [
        {
            "code": "163WC1500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse, Community Health",
            "state": "MN",
            "license": "R121223-7",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE",
            "identifier": "164398",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "8300115",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "234933100",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF MN",
            "identifier": "4605640",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PARTNERS",
            "identifier": "87361",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE",
            "identifier": "1031834",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA",
            "identifier": "870000829",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.