Prestige Health Care Services

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

337387 Issued in MN

Legal business name

PRESTIGE HEALTH CARE SERVICES

Practice address

10937 Robinson Dr NW
Coon Rapids, MN 55433-4248

Phone

(763) 607-5184

Fax

(763) 226-2378

NPI assigned

Aug 23, 2007

Organization subpart

No

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

Authorized official

Name

Miss Tabitha R Kyambadde

Title

Administrator

Phone

(763) 607-5184

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1187827200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1187827200000",
    "number": "1033302971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10937 ROBINSON DR NW",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554334248",
            "telephone_number": "763-607-5184",
            "fax_number": "763-226-2378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10937 ROBINSON DR NW",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554334248",
            "telephone_number": "763-607-5184",
            "fax_number": "763-226-2378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRESTIGE HEALTH CARE SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-23",
        "last_updated": "2007-08-23",
        "status": "A",
        "authorized_official_last_name": "KYAMBADDE",
        "authorized_official_first_name": "TABITHA",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "763-607-5184",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "MN",
            "license": "337387",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLASS F",
            "identifier": "337386",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLASS A",
            "identifier": "337387",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christopher A Powers, MD
• David A. Prahl Jr., CHID
• Premier Health of Coon Rapids, Inc
• Premier Mobility
• Premier Physical Therapy Centers, Inc.
• Prestige Healthcare Solutions LLC
• Kevin G Preston, CRNA
• Laura Price, DPT
• Kyelee Prince
• Paige Prince

• Home Health Agency in Coon Rapids, MN
• Providers in Coon Rapids, MN by specialty
• Home Health Agency in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2007; 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.