Kingsway Healthcare Services LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

KINGSWAY HEALTHCARE SERVICES LLC

Practice address

9248 Queens GDNS
Brooklyn Park, MN 55443-1641

Phone

(763) 221-5248

NPI assigned

Sep 27, 2019

Last updated

Sep 27, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kingdom Kanu

Title

Administrator

Phone

(763) 221-5248

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1569542400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1569542400000",
    "number": "1801447099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12050 NORWAY ST NW",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554482242",
            "telephone_number": "763-221-5248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9248 QUEENS GDNS",
            "city": "BROOKLYN PARK",
            "state": "MN",
            "postal_code": "554431641",
            "telephone_number": "763-221-5248"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2847 Brookdale Dr",
            "address_purpose": "LOCATION",
            "city": "Brooklyn Park",
            "state": "MN",
            "postal_code": "554441844",
            "country_code": "US",
            "telephone_number": "763-221-5248",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "KINGSWAY HEALTHCARE SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-27",
        "last_updated": "2019-09-27",
        "status": "A",
        "authorized_official_last_name": "KANU",
        "authorized_official_first_name": "KINGDOM",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "763-221-5248"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Christopher Michael Kissell, FNP
• Omer J Kissi
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• Erin Mackenzie Klukas, OD
• Madalyn Marie Knase, PA-C

• Home Health Agency in Brooklyn Park, MN
• Providers in Brooklyn Park, MN by specialty
• Home Health Agency in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2019; 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.