NPIMap

Organization Active NPI

Brookdale Senior Living Communities, Inc.

Doing business as Brookdale Plymouth

  • Assisted Living Facility
  • Plymouth, MN
National Provider Identifier
1720144363
Registry record updated Apr 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
Legal business name
BROOKDALE SENIOR LIVING COMMUNITIES, INC.
Doing business as
Brookdale Plymouth
Practice address
15855 22ND Ave N
Plymouth, MN 55447-6452
Phone
(763) 476-8200
NPI assigned
Dec 28, 2006
Last updated
Apr 4, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2024

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

Authorized official

Name
Anna Munoz
Title
Assistant Secretary
Phone
(414) 918-5443

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X Primary

Addresses

Primary practice location

15855 22ND Ave N
Plymouth, MN 55447-6452

Mailing address

15855 22ND Ave N
Plymouth, MN 55447-6452
Phone (763) 476-8200

Other names 1

  • Brookdale Plymouth Doing business as

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
24D1031567Brookdale Plymouth15855 22ND Ave N, Plymouth, MN 55447Certificate of waiverOct 3, 2026

National Provider Directory

National Provider Directory
Tax ID family
Brookdale Senior Living Communties Inc248 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 14

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712188800000",
    "number": "1720144363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15855 22ND AVE N",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554476452",
            "telephone_number": "763-476-8200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15855 22ND AVE N",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554476452",
            "telephone_number": "763-476-8200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROOKDALE SENIOR LIVING COMMUNITIES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-28",
        "last_updated": "2024-04-04",
        "certification_date": "2024-04-04",
        "status": "A",
        "authorized_official_last_name": "MUNOZ",
        "authorized_official_first_name": "ANNA",
        "authorized_official_title_or_position": "ASSISTANT SECRETARY",
        "authorized_official_telephone_number": "414-918-5443"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brookdale Plymouth",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Apr 4, 2024; 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.