Market Plaza Consolidated, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

MARKET PLAZA CONSOLIDATED, LLC

Doing business as

Village Shores

Practice address

6501 Woodlake Dr
Richfield, MN 55423-1392

Phone

(612) 861-1186

NPI assigned

Dec 31, 2021

Organization subpart

No

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

Authorized official

Name

Niki Ballingrud, RN

Title

RN

Phone

(612) 720-0591

Specialties & licenses 1

Addresses

Other names 1

• Village Shores Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1640908800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1640908800000",
    "number": "1326709478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9759 GABLE DR",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553474329",
            "telephone_number": "612-720-0591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6501 WOODLAKE DR",
            "city": "RICHFIELD",
            "state": "MN",
            "postal_code": "554231392",
            "telephone_number": "612-861-1186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARKET PLAZA CONSOLIDATED, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-31",
        "last_updated": "2021-12-31",
        "certification_date": "2021-12-31",
        "status": "A",
        "authorized_official_last_name": "BALLINGRUD",
        "authorized_official_first_name": "NIKI",
        "authorized_official_title_or_position": "RN",
        "authorized_official_telephone_number": "612-720-0591",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Village Shores",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Assisted Living Facility in Richfield, MN
• Providers in Richfield, 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 Dec 31, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.