MEDICARE: NBCC 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	314000000X	Skilled Nursing Facility

General Provider Information

NPI Number	:	1871462416
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NBCC LLC

Provider Business Mailing Address
First Line	:	805 6TH AVE NW
Second Line	:
City	:	NEW BRIGHTON
State	:	MN
Zip	:	55112-2717
Country	:	US
Telephone Number	:	651-633-7200
Fax Number	:

Provider Business Practice Location Address
First Line	:	805 6TH AVE NW
Second Line	:
City	:	NEW BRIGHTON
State	:	MN
Zip	:	55112-2717
Country	:	US
Telephone Number	:	651-633-7200
Fax Number	:

Authorized Official
Title or Position	:	CONSULTANT
Name	:	REUBEN KNOBEL
Credential	:
Telephone Number	:	516-940-5100

Provider Enumeration Date	:	11/03/2025
Last Update Date	:	11/03/2025

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