Kim Tracy Ross, LADC

Primary specialty

CounselorTaxonomy code 101Y00000X

License

306150 Issued in MN

Practice address

7580 160TH St W
Lakeville, MN 55044-8348

Phone

(507) 273-1084

NPI assigned

Sep 9, 2021

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Life Development Resources, PA

  • Community/Behavioral Health Agency
  • Lakeville, MN
  • NPI 1902953169
  NPD Authorized official

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

{
    "created_epoch": "1631145600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631145600000",
    "number": "1619646031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12147 GANTRY LN",
            "city": "APPLE VALLEY",
            "state": "MN",
            "postal_code": "551246297",
            "telephone_number": "507-273-1084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7580 160TH ST W",
            "city": "LAKEVILLE",
            "state": "MN",
            "postal_code": "550448348",
            "telephone_number": "507-273-1084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSS",
        "first_name": "KIM",
        "middle_name": "TRACY",
        "name_prefix": "Ms.",
        "credential": "LADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-09",
        "last_updated": "2021-09-09",
        "certification_date": "2021-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MN",
            "license": "306150",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kimr@lifedrs.com",
            "affiliation": "N",
            "endpointDescription": "Work email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "7580 160th St W",
            "city": "Lakeville",
            "state": "MN",
            "country_code": "US",
            "postal_code": "550448348",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Rachel Rolf, PA-C
• Joshua Kelly Rolfes, DPT
• Karina Roman, LMT
• Brian Howard Roscoe, PSYD LP
• Roskamp Consulting Services, Inc
• Andrea Rosson
• Jodi Ranae Rother, HIS
• Rozmarin Family Chiropractic, P. a.
• Lindsay Rose Rozmarin, D.C.
• RST Investment Group Inc.

• Counselor in Lakeville, MN
• Providers in Lakeville, MN by specialty
• Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2021; 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.