Organization Active NPI

Kingdom Culture Ministries Inc.

  • Licensed Practical Nurse
  • Fort Lauderdale, FL
National Provider Identifier
1609748268
Registry record updated Sep 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
Legal business name
KINGDOM CULTURE MINISTRIES INC.
Practice address
3330 NW 63Rd St
Fort Lauderdale, FL 33309-1611
Phone
(954) 825-8295
NPI assigned
Sep 22, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2025

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

Authorized official

Name
Idris BozemanNPI 1275478273
Title
Owner/Operator
Phone
(954) 825-8295

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical NurseGroup: 193200000X MULTI-SPECIALTY GROUP 164W00000X Primary

Addresses

Primary practice location

3330 NW 63Rd St
Fort Lauderdale, FL 33309-1611

Mailing address

PO Box 590342
Fort Lauderdale, FL 33359-0342
Phone (954) 825-8295

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1758499200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758499200000",
    "number": "1609748268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 590342",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333590342",
            "telephone_number": "954-825-8295",
            "fax_number": "954-825-8295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3330 NW 63RD ST",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333091611",
            "telephone_number": "954-825-8295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KINGDOM CULTURE MINISTRIES INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-09-22",
        "last_updated": "2025-09-22",
        "certification_date": "2025-09-22",
        "status": "A",
        "authorized_official_last_name": "BOZEMAN",
        "authorized_official_first_name": "IDRIS",
        "authorized_official_title_or_position": "OWNER/OPERATOR",
        "authorized_official_telephone_number": "954-825-8295"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Licensed Practical Nurse",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lauderdale, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2025; 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.