Shining Light Care LLC

Primary specialty

Case Management AgencyTaxonomy code 251B00000X

Legal business name

SHINING LIGHT CARE LLC

Practice address

20270 Mallard Way
Rogers, MN 55374-8716

Phone

(612) 701-2669

NPI assigned

May 21, 2025

Organization subpart

No

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

Authorized official

Name

Anita Nain Fondikum

Title

Ceo

Phone

(612) 701-2669

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1747785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747785600000",
    "number": "1104618404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20270 MALLARD WAY",
            "city": "ROGERS",
            "state": "MN",
            "postal_code": "553748716",
            "telephone_number": "612-701-2669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20270 MALLARD WAY",
            "city": "ROGERS",
            "state": "MN",
            "postal_code": "553748716",
            "telephone_number": "612-701-2669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHINING LIGHT CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-05-21",
        "last_updated": "2025-05-21",
        "certification_date": "2025-05-21",
        "status": "A",
        "authorized_official_last_name": "FONDIKUM",
        "authorized_official_first_name": "ANITA",
        "authorized_official_middle_name": "NAIN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "612-701-2669"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Jeffrey Alan Smith, D.D.S.

• Case Management Agency in Rogers, MN
• Providers in Rogers, MN by specialty
• Case Management Agency in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 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.