Individual provider Active NPI

Kou Vang

  • Family Nurse Practitioner
  • Woodbury, MN
National Provider Identifier
1245092402
Registry record updated Apr 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11215 Issued in MN
Practice address
8675 Valley Creek Rd
Woodbury, MN 55125-2337
Phone
(651) 241-3000
NPI assigned
Jan 24, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 11215 MN Primary

Addresses

Primary practice location

8675 Valley Creek Rd
Woodbury, MN 55125-2337

Mailing address

2925 Chicago Ave
Minneapolis, MN 55407-1321
Phone (612) 262-9000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kvang362860@excellian.direct.allina.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240416002329 MN Practitioner - Nurse Practitioner 0244679876 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Allina Health SystemGroup PAC ID 4587573613, 3,844 clinicians

Practice addresses (Care Compare)

14655 Galaxie Ave
Apple Valley, MN 55124-8602
Phone (651) 241-3779

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
11215MNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Allina Health System CurrentSince Jun 2, 2024 Accepting new patients
Allina Health System Current Accepting new patients
Allina Health System CurrentSince Jun 2, 2024 Accepting new patients
Allina Health System Past Accepting new patients

Locations

440 Elm St E
Annandale, MN 55302
Phone (320) 682-5225

755 Crossroads Campus Dr NE
Buffalo, MN 55313
Phone (763) 684-6300

11269 Jefferson Hwy N
Champlin, MN 55316
Phone (763) 236-0600

2215 Park Ave
Minneapolis, MN 55404
Phone (612) 775-8800

2925 Chicago Ave
Minneapolis, MN 55407
Phone (612) 262-4813

1021 Bandana Blvd E
Ste 100
Saint Paul, MN 55108
Phone (877) 414-2533

14655 Galaxie Ave
Saint Paul, MN 55124
Phone (952) 432-4141

8675 Valley Creek Rd
Woodbury, MN 55125
Phone (651) 241-3000

Interoperability endpoints

  • Direct secure messaging: kvang362860@excellian.direct.allina.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1706054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714435200000",
    "number": "1245092402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2925 CHICAGO AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554071321",
            "telephone_number": "612-262-9000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8675 VALLEY CREEK RD",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551252337",
            "telephone_number": "651-241-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANG",
        "first_name": "KOU",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-01-24",
        "last_updated": "2024-04-30",
        "certification_date": "2024-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "11215",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kvang362860@excellian.direct.allina.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/PDF/TXT",
            "address_1": "8675 Valley Creek Rd",
            "city": "Woodbury",
            "state": "MN",
            "country_code": "US",
            "postal_code": "551252337",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Woodbury, MN

Sources for this page

Verify at the official NPI Registry.