PHS LAKE MINNETONKA LLC
NPI 1184737926
Skilled Nursing Facility in Spring Park, MN

Active since August 16, 2006
4515 SHORELINE DR, SPRING PARK, MN 55384(952) 471-4001(651) 631-6449 Get Directions Write a Review

NPPES record last updated: November 11, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Nov 11, 2025, Jan 27, 2022, Mar 6, 2019 and 1 more (4 updates tracked since 2017).

About Phs Lake Minnetonka Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PHS LAKE MINNETONKA LLC (NPI 1184737926) is a healthcare organization registered as a skilled nursing facility in Spring Park, Minnesota and active in the NPI registry since August 2006. The organization lists Mark Meyer, Cfo, as its authorized official.

NPPES Registry Identity

NPI1184737926
Entity TypeOrganization
Primary Taxonomy314000000X
Legal Business NamePHS LAKE MINNETONKA LLC
Location Address4515 SHORELINE DRSpring Park, MN 55384-8500
Mailing Address4527 Shoreline DrSpring Park, MN 55384-8706 · (952) 471-4001 · Fax (651) 631-6449
Fax(651) 631-6449
Organization SubpartNo
Authorized OfficialMark MeyerCfo · (651) 631-6102
Enumeration DateAugust 16, 2006
Last NPPES UpdateNovember 11, 20254 updates tracked since enumeration
NPPES CertifiedNovember 11, 2025
NPI 1184737926 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtySkilled Nursing FacilityNursing & Custodial Care Facilities
Taxonomy Code314000000X
Definition

(1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis.

4515 SHORELINE DR, Spring Park, MN 55384

Other Names 1

Other NameLake Minnetonka Shores

Other Identifiers 5

Other7122641Medica
Other22857Health Partners
Medicaid172043100MN
OtherNH0041MN · Ucare
Other9625TWBcbs

Accepted Insurance

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Phs Lake Minnetonka LLC's NPI number?

The NPI number for Phs Lake Minnetonka LLC is 1184737926. It was assigned to this organization in the NPPES registry on August 16, 2006. The provider is also known as Lake Minnetonka Shores.

Where is Phs Lake Minnetonka LLC located?

Phs Lake Minnetonka LLC is located at 4515 Shoreline Dr, Spring Park, MN 55384. The listed phone number is (952) 471-4001.

What is Phs Lake Minnetonka LLC's specialty?

The primary specialty registered for this NPI is Skilled Nursing Facility with taxonomy code 314000000X.

What insurance does Phs Lake Minnetonka LLC accept?

Health plans from HealthPartners list Phs Lake Minnetonka LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Phs Lake Minnetonka LLC was last updated on November 11, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.