4685 Park Nicollet Avenue Opco LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

4685 PARK NICOLLET AVENUE OPCO LLC

Practice address

4685 Park Nicollet Ave SE
Prior Lake, MN 55372-3926

Phone

(952) 226-9200

Fax

(612) 360-2331

NPI assigned

Jul 1, 2025

Last updated

Sep 22, 2025By the provider in NPPES

Organization subpart

Yes

Parent organization

WELLTOWER TRS HOLDCO LLCAs reported in NPPES

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

Authorized official

Name

Kate Ryg

Title

Clinical Reimbursement Manager

Phone

(763) 486-9187

Specialties & licenses 1

Addresses

Part of

Welltower TRS Holdco LLC

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

{
    "created_epoch": "1751328000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758499200000",
    "number": "1093604456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5900 CLEARWATER DR STE 500",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553438961",
            "telephone_number": "763-486-9187",
            "fax_number": "612-360-2331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4685 PARK NICOLLET AVE SE",
            "city": "PRIOR LAKE",
            "state": "MN",
            "postal_code": "553723926",
            "telephone_number": "952-226-9200",
            "fax_number": "612-360-2331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "4685 PARK NICOLLET AVENUE OPCO LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WELLTOWER TRS HOLDCO LLC",
        "enumeration_date": "2025-07-01",
        "last_updated": "2025-09-22",
        "certification_date": "2025-09-22",
        "status": "A",
        "authorized_official_last_name": "RYG",
        "authorized_official_first_name": "KATE",
        "authorized_official_title_or_position": "CLINICAL REIMBURSEMENT MANAGER",
        "authorized_official_telephone_number": "763-486-9187"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Steven Alan Aaker, DDS
• Samira O Abdalla
• Zakaria Osman Abdullahi
• Jed W Adams, CRNA
• Advantage Chiropractic and Wellness

• Assisted Living Facility in Prior Lake, MN
• Providers in Prior Lake, MN by specialty
• Assisted Living Facility in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2025; 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.