Organization Active NPI

Crescent Recuperative Care LLC

  • Home Health Agency
  • Plymouth, MN
National Provider Identifier
1679439764
Registry record updated Jan 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
CRESCENT RECUPERATIVE CARE LLC
Practice address
10010 36TH PL N
Plymouth, MN 55441-1654
Phone
(612) 234-0088
NPI assigned
Jan 1, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2026

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

Authorized official

Name
Qiyam Jahangir
Title
Owner/Authorized Official
Phone
(612) 607-2006

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

10010 36TH PL N
Plymouth, MN 55441-1654

Mailing address

10010 36TH PL N
Plymouth, MN 55441-1654
Phone (612) 234-0088

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1767225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1767744000000",
    "number": "1679439764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10010 36TH PL N",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554411654",
            "telephone_number": "612-234-0088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10010 36TH PL N",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554411654",
            "telephone_number": "612-234-0088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRESCENT RECUPERATIVE CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-01-01",
        "last_updated": "2026-01-07",
        "certification_date": "2026-01-07",
        "status": "A",
        "authorized_official_last_name": "JAHANGIR",
        "authorized_official_first_name": "QIYAM",
        "authorized_official_title_or_position": "OWNER/AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "612-607-2006"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2026; 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.