NPIMap

Organization Active NPI

Rose of Sharon

  • Skilled Nursing Facility
  • Roseville, MN
National Provider Identifier
1295087864
Registry record updated Oct 8, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
201729 Issued in MN
Legal business name
ROSE OF SHARON
Practice address
1000 Lovell Ave W
Roseville, MN 55113-4459
Phone
(651) 484-3378
Fax
(651) 484-8982
NPI assigned
Oct 8, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2012

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

Authorized official

Name
Ms. Maya Lynn Ninnemann, COTA
Title
Certified Occupational Therapy Assi
Phone
(651) 484-3378

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 201729 MN Primary

Addresses

Primary practice location

1000 Lovell Ave W
Roseville, MN 55113-4459

Mailing address

1000 Lovell Ave W
Roseville, MN 55113-4459

National Provider Directory

National Provider Directory
Tax ID family
Belair Nursing Home14 organizations share this tax ID, including this one

Other organizations with this tax ID 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1349654400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1349654400000",
    "number": "1295087864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 LOVELL AVE W",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551134459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 LOVELL AVE W",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551134459",
            "telephone_number": "651-484-3378",
            "fax_number": "651-484-8982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROSE OF SHARON",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-08",
        "last_updated": "2012-10-08",
        "status": "A",
        "authorized_official_last_name": "NINNEMANN",
        "authorized_official_first_name": "MAYA",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "CERTIFIED OCCUPATIONAL THERAPY ASSI",
        "authorized_official_telephone_number": "651-484-3378",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "COTA"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MN",
            "license": "201729",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2012; 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.