MEDICARE: NEXTCARE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1356168454
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEXTCARE LLC

Provider Business Mailing Address
First Line	:	301 E LAKE ST STE 207
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55408-2449
Country	:	US
Telephone Number	:	612-584-3917
Fax Number	:	612-584-3923

Provider Business Practice Location Address
First Line	:	301 E LAKE ST STE 207
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55408-2449
Country	:	US
Telephone Number	:	612-584-3917
Fax Number	:	612-584-3923

Authorized Official
Title or Position	:	CEO
Name	:	KHADRA ABDULLAHI JAMA
Credential	:	RN,BSN,PHN
Telephone Number	:	612-644-2743

Provider Enumeration Date	:	09/21/2024
Last Update Date	:	09/21/2024

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