Individual provider Active NPI

Roma KC

  • Registered Nurse
  • Lakeville, MN
National Provider Identifier
1215842778
Registry record updated Aug 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
2464156 Issued in MN
Practice address
16973 Hamilton CT
Lakeville, MN 55044-9591
Phone
(612) 787-8772
NPI assigned
Aug 18, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 2464156 MN Primary

Addresses

Primary practice location

16973 Hamilton CT
Lakeville, MN 55044-9591

Mailing address

16973 Hamilton CT
Lakeville, MN 55044-9591

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1787011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787011200000",
    "number": "1215842778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16973 HAMILTON CT",
            "city": "LAKEVILLE",
            "state": "MN",
            "postal_code": "550449591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16973 HAMILTON CT",
            "city": "LAKEVILLE",
            "state": "MN",
            "postal_code": "550449591",
            "telephone_number": "612-787-8772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KC",
        "first_name": "ROMA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-08-18",
        "last_updated": "2026-08-18",
        "certification_date": "2026-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MN",
            "license": "2464156",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeville, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2026; 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.