Individual provider Active NPI

Kimloan Sloss

  • Nurse Practitioner
  • Chaska, MN
National Provider Identifier
1659089118
Registry record updated Nov 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
9722 Issued in MN
Practice address
1415 Ravoux LN
Chaska, MN 55318-2526
Phone
(952) 361-0080
Fax
(952) 314-9613
NPI assigned
Nov 14, 2022
Last updated
Nov 14, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 9722 MN Primary

Addresses

Primary practice location

1415 Ravoux LN
Chaska, MN 55318-2526

Mailing address

1415 Ravoux LN
Chaska, MN 55318-2526
Phone (952) 361-0080

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
I20230209000598 MN Order and Referring Only - Nurse Practitioner 0749652204

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9722MNMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Acute Home Health Care of MN CurrentSince Nov 20, 2022 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1668384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668384000000",
    "number": "1659089118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1415 RAVOUX LN",
            "city": "CHASKA",
            "state": "MN",
            "postal_code": "553182526",
            "telephone_number": "952-361-0080",
            "fax_number": "952-314-9613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1415 RAVOUX LN",
            "city": "CHASKA",
            "state": "MN",
            "postal_code": "553182526",
            "telephone_number": "952-361-0080",
            "fax_number": "952-314-9613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SLOSS",
        "first_name": "KIMLOAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-14",
        "last_updated": "2022-11-14",
        "certification_date": "2022-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MN",
            "license": "9722",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chaska, MN

Sources for this page

Verify at the official NPI Registry.