KSP Medical LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

KSP MEDICAL LLC

Practice address

15731 Fremont Way
Apple Valley, MN 55124-6531

Phone

(612) 599-4169

NPI assigned

Jul 22, 2024

Organization subpart

No

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

Authorized official

Name

Abdullahi Mohamed

Title

President

Phone

(612) 599-4169

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1721606400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721606400000",
    "number": "1902634009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7635 148TH ST W # 135",
            "city": "APPLE VALLEY",
            "state": "MN",
            "postal_code": "551247800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15731 FREMONT WAY",
            "city": "APPLE VALLEY",
            "state": "MN",
            "postal_code": "551246531",
            "telephone_number": "612-599-4169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KSP MEDICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-22",
        "last_updated": "2024-07-22",
        "certification_date": "2024-07-22",
        "status": "A",
        "authorized_official_last_name": "MOHAMED",
        "authorized_official_first_name": "ABDULLAHI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "612-599-4169"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Judith Ann Kramer
• Jamie Kranz, FNP
• Melissa Krapf, ATC
• Matthew Kratz, DDS
• Britnie Krueger, MA, LMFT
• Paul Anthony Kustermann
• Emily A Lagace, MD
• Miles Richard Lahr, RPH., CDE
• Suzanne Ellen Lahr, PHARMD
• Lakeview Home Health Care Inc.

• Durable Medical Equipment & Medical Supplies in Apple Valley, MN
• Providers in Apple Valley, MN by specialty
• Durable Medical Equipment & Medical Supplies in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2024; 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.