NPIMap

Organization Active NPI

Nightingale Home Healthcare of Minnesota, Inc

  • Home Health Agency
  • Minnetonka, MN
National Provider Identifier
1356332803
Registry record updated Mar 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
NIGHTINGALE HOME HEALTHCARE OF MINNESOTA, INC
Practice address
10550 Wayzata Blvd Ste 1
Minnetonka, MN 55305-1523
Phone
(763) 545-3131
Fax
(763) 546-1191
NPI assigned
Nov 3, 2005
Last updated
Mar 29, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2022

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

Authorized official

Name
Dev A Brar
Title
President
Phone
(317) 334-7777

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X NU Primary

Addresses

Primary practice location

10550 Wayzata Blvd Ste 1
Minnetonka, MN 55305-1523

Mailing address

PO Box 1710
Carmel, IN 46082-1710
Phone (866) 334-7777

Other names 1

  • Nightingale Home Healthcare Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041111000921 MN Part A Provider - Home Health Agency 9436112216 Practice locations: Minnetonka, MN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1356332803. Details of each certification follow.

Home health agency certification: CCN 248085

Legal name
NIGHTINGALE HOME HEALTHCARE OF MINNESOTA INC
Doing business as
NIGHTINGALE HOME HEALTHCARE
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Mar 18, 2005
Last certification
Nov 9, 2016
Ownership / control type
Proprietary
Organization structure
CorporationProprietary
Incorporated
Sep 28, 2004 in IN
Enrollment address
10550 Wayzata Blvd
Ste 1
Minnetonka, MN 55305-1523
HHA Branch

Care Compare: Home health agency

Medicare Care Compare
Listed as
Nightingale Home HealthcareCCN 248085 · All quality measures
Overall star rating
3.5 of 5
Ownership
Proprietary
Certified
Mar 18, 2005
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

National Provider Directory

National Provider Directory

Locations

10550 Wayzata Blvd
Minnetonka, MN 55305
Phone (763) 545-3131

Ownership & related parties

All disclosed owners & managing parties 4

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Homecare Providers Inc Organization, Carmel, IN 5% Or Greater Direct Ownership Interest Nov 28, 2006 100%
Dev a Brar Individual 5% Or Greater Indirect Ownership InterestPresident Sep 28, 2004 100%
Corporate OfficerPresident Sep 28, 2004 100%
Corporate DirectorPresident Sep 28, 2004 100%
W-2 Managing EmployeePresident Sep 28, 2004 100%
David a Pratt Individual OtherCfo Mar 31, 2010
Piper L Brar Individual OtherAssistant Director Jul 19, 2008

Facilities with the same owner 9

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

Affiliated clinicians 3

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1130976000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1648512000000",
    "number": "1356332803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1710",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460821710",
            "telephone_number": "866-334-7777",
            "fax_number": "866-878-0094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10550 WAYZATA BLVD STE 1",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553051523",
            "telephone_number": "763-545-3131",
            "fax_number": "763-546-1191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NIGHTINGALE HOME HEALTHCARE OF MINNESOTA, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-03",
        "last_updated": "2022-03-29",
        "certification_date": "2022-03-29",
        "status": "A",
        "authorized_official_last_name": "BRAR",
        "authorized_official_first_name": "DEV",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "317-334-7777"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Nightingale Home Healthcare",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Nightingale Home Healthcare",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Minnetonka, MN

Sources for this page

Verify at the official NPI Registry.