Loren Dale Kmett, AUDIOLOGIST

Primary specialty

AudiologistTaxonomy code 231H00000X

License

7307 Issued in MN

Practice address

215 N 3Rd St
Brainerd, MN 56401-3331

Phone

(218) 829-2162

Fax

(218) 828-5013

NPI assigned

Oct 26, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1224979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1224979200000",
    "number": "1447403175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 N 3RD ST",
            "city": "BRAINERD",
            "state": "MN",
            "postal_code": "564013331",
            "telephone_number": "218-829-2162",
            "fax_number": "218-828-5013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 N 3RD ST",
            "city": "BRAINERD",
            "state": "MN",
            "postal_code": "564013331",
            "telephone_number": "218-829-2162",
            "fax_number": "218-828-5013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KMETT",
        "first_name": "LOREN",
        "middle_name": "DALE",
        "name_prefix": "Mr.",
        "credential": "AUDIOLOGIST",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-10-26",
        "last_updated": "2008-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "MN",
            "license": "7307",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE",
            "identifier": "161081",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "96G70KM",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "266652900",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Rodney Lamar Knowles, M.S.
• Jean Kocer, MSW, LICSW
• Kathleen Diane Kongsjord, LPCC
• John Phillip Koop, PHARM. D.
• Jaclyn Ann Kostecka, PA-C

• Audiologist in Brainerd, MN
• Providers in Brainerd, MN by specialty
• Audiologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2008; 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.