Organization Active NPI

Crestview Residences LLC

  • Skilled Nursing Facility
  • Minneapolis, MN
National Provider Identifier
1477423556
Registry record updated Nov 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
CRESTVIEW RESIDENCES LLC
Practice address
4444 Reservoir Blvd
Minneapolis, MN 55421-3255
Phone
(763) 782-1611
NPI assigned
Nov 5, 2025
Last updated
Nov 5, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2025

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

Authorized official

Name
Josh Legum
Title
President
Phone
(507) 203-1000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X NU Primary

Addresses

Primary practice location

4444 Reservoir Blvd
Minneapolis, MN 55421-3255

Mailing address

1345 Corporate Center Curv
Eagan, MN 55121-1295

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
24D0651360The Residences at Crestview4444 Reservoir Blvd NE, Columbia Heights, MN 55421Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1762300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762300800000",
    "number": "1477423556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1345 CORPORATE CENTER CURV",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551211295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4444 RESERVOIR BLVD",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554213255",
            "telephone_number": "763-782-1611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRESTVIEW RESIDENCES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-11-05",
        "last_updated": "2025-11-05",
        "certification_date": "2025-11-05",
        "status": "A",
        "authorized_official_last_name": "LEGUM",
        "authorized_official_first_name": "JOSH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "507-203-1000"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2025; 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.