Organization Active NPI

New Dynamic Home Care LLC

  • Home Health Agency
  • St Louis Park, MN
National Provider Identifier
1538885702
Registry record updated Nov 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
NEW DYNAMIC HOME CARE LLC
Practice address
5821 Cedar Lake Rd S Ofc No108
St Louis Park, MN 55416-1487
Phone
(763) 245-1730
NPI assigned
Oct 18, 2022
Last updated
Nov 8, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2024

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

Authorized official

Name
Sahara Aden
Title
RN/ Owner
Phone
(763) 245-1730

Specialties & licenses 1

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

Addresses

Primary practice location

5821 Cedar Lake Rd S Ofc No108
St Louis Park, MN 55416-1487

Mailing address

7760 France Ave S # 1184
Bloomington, MN 55435-5800
Phone (763) 245-1730

Other identifiers 1

IdentifierTypeStateIssuer
39455MedicaidMN

National Provider Directory

National Provider Directory

Locations

7760 France Ave S
#1184
Bloomington, MN 55435

NPI Registry JSON

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

{
    "created_epoch": "1666051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731024000000",
    "number": "1538885702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7760 FRANCE AVE S # 1184",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554355800",
            "telephone_number": "763-245-1730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5821 CEDAR LAKE RD S OFC NO108",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554161487",
            "telephone_number": "763-245-1730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW DYNAMIC HOME CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-18",
        "last_updated": "2024-11-08",
        "certification_date": "2024-11-08",
        "status": "A",
        "authorized_official_last_name": "ADEN",
        "authorized_official_first_name": "SAHARA",
        "authorized_official_title_or_position": "RN/ OWNER",
        "authorized_official_telephone_number": "763-245-1730"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39455",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St Louis Park, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2024; 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.