Imo I Kalla, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R118728-1 Issued in MN

Practice address

2251 Connecticut Avenue S
HP Central MN Clinics
Sartell, MN 56377-2486

Phone

(320) 253-5220

Fax

(320) 203-2113

NPI assigned

Apr 6, 2007

Last updated

Dec 20, 2011By the provider in NPPES

Sex

Female

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 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ikalla281485@direct.centracare.com
• Direct secure messaging: ikalla572670@direct.centracare.com

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

• Unity Family Healthcare

  dba Little Falls Orthopedics

  • Orthopaedic Surgery Physician
  • Little Falls, MN
  • NPI 1326234006
  Medicare reassignment NPD
• Unity Family Healthcare

  dba St. Gabriel's Hospital

  • Critical Access Hospital
  • Little Falls, MN
  • NPI 1780630939
  Medicare reassignment NPD
• Unity Family Healthcare

  dba Family Medical Center

  • Family Medicine Physician
  • Little Falls, MN
  • NPI 1275762650
  NPD
• Unity Family Healthcare

  dba CHI Health at Home

  • Home Health Agency
  • Little Falls, MN
  • NPI 1952329047
  NPD
• Little Falls Medical Center, PA

  • Family Medicine Physician
  • Little Falls, MN
  • NPI 1669546628
  NPD (past)

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

{
    "created_epoch": "1175817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1324339200000",
    "number": "1548383664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8170 33RD AVE S",
            "address_2": "MS21110Q",
            "city": "FREEPORT",
            "state": "MN",
            "postal_code": "554254516",
            "telephone_number": "952-883-5375",
            "fax_number": "320-203-2113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2251 CONNECTICUT AVENUE S",
            "address_2": "HP CENTRAL MN CLINICS",
            "city": "SARTELL",
            "state": "MN",
            "postal_code": "563772486",
            "telephone_number": "320-253-5220",
            "fax_number": "320-203-2113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KALLA",
        "first_name": "IMO",
        "middle_name": "I",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-06",
        "last_updated": "2011-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "R118728-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "177515400",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Matthew Stephen Justin
• Deepak Kademani, M.D.
• Michelle Lynn Kaiser, M.S., LPCC
• Sara Elizabeth Kalis
• Samantha Kalkbrenner
• Rebecca Kalla
• Kerry M Kallas, M.D.
• Wilbur Wayne Kalstrom, RPH
• Brian Peter Kampa, PT
• Michael Kampa, A.T.R.

• Family Nurse Practitioner in Sartell, MN
• Providers in Sartell, MN by specialty
• Family Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.