Organization Active NPI

Nordmetro Adult Rehabilitation LLC

  • Clinic/Center
  • Maple Grove, MN
National Provider Identifier
1871479857
Registry record updated Aug 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
NORDMETRO ADULT REHABILITATION LLC
Practice address
10189 Shadyview LN N
Maple Grove, MN 55311-5713
Phone
(507) 291-4198
NPI assigned
Aug 14, 2025
Last updated
Aug 14, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2025

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

Authorized official

Name
Tanyi Tiku Ngwi
Title
Onwer
Phone
(507) 291-4198

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X NU Primary

Addresses

Primary practice location

10189 Shadyview LN N
Maple Grove, MN 55311-5713

Mailing address

10189 Shadyview LN N
Maple Grove, MN 55311-5713

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1755129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1755129600000",
    "number": "1871479857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10189 SHADYVIEW LN N",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553115713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10189 SHADYVIEW LN N",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553115713",
            "telephone_number": "507-291-4198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORDMETRO ADULT REHABILITATION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-08-14",
        "last_updated": "2025-08-14",
        "certification_date": "2025-08-14",
        "status": "A",
        "authorized_official_last_name": "NGWI",
        "authorized_official_first_name": "TANYI",
        "authorized_official_middle_name": "TIKU",
        "authorized_official_title_or_position": "ONWER",
        "authorized_official_telephone_number": "507-291-4198"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maple Grove, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2025; 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.