Crest Ridge Residences LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

CREST RIDGE RESIDENCES LLC

Practice address

10955 Wayzata Blvd
Minnetonka, MN 55305-1535

Phone

(612) 874-3432

NPI assigned

Oct 3, 2018

Organization subpart

No

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

Authorized official

Name

Andrea Nye

Title

Regional Director Assisted Living

Phone

(612) 599-6788

Specialties & licenses 1

Addresses

Other names 1

• Orchards of Minnetonka Doing business as

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

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1538524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1538524800000",
    "number": "1922583178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2722 PARK AVENUE SOUTH - ATTENTION JILL NOKLEBY KAISER",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "55407",
            "telephone_number": "612-874-3431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10955 WAYZATA BLVD",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553051535",
            "telephone_number": "612-874-3432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CREST RIDGE RESIDENCES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-03",
        "last_updated": "2018-10-03",
        "status": "A",
        "authorized_official_last_name": "NYE",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_title_or_position": "REGIONAL DIRECTOR ASSISTED LIVING",
        "authorized_official_telephone_number": "612-599-6788"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Orchards of Minnetonka",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jennifer Leigh Cox, APRN
• Traci Cox, NP-C
• Jessica Dodds Crance, F.N.P.
• Cody Crawford
• Kimberly D Creel, ARNP
• Joan Cromwell
• Austin Croteau
• Lauren Crowley-Cunningham, M.A., CCC-SLP
• Jakayla Crowley
• Gavin Crowther, APRN

• Assisted Living Facility in Minnetonka, MN
• Providers in Minnetonka, MN by specialty
• Assisted Living Facility in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2018; 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.