Seipati Valerie Kgomo

Primary specialty

Personal Care AttendantTaxonomy code 3747P1801X

License

3747P1801X Issued in MN

Practice address

364 Sunset Ave
306
Lake Park, MN 60506

Phone

(218) 234-5238

NPI assigned

Dec 20, 2024

Last updated

Dec 20, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1734652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734652800000",
    "number": "1942018122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "178 MEADOW LN APT 203",
            "city": "DETROIT LAKES",
            "state": "MN",
            "postal_code": "565012455",
            "telephone_number": "218-234-5238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "364 SUNSET AVE",
            "address_2": "306",
            "city": "LAKE PARK",
            "state": "MN",
            "postal_code": "60506",
            "telephone_number": "218-234-5238"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "178 Meadow Ln Apt 203",
            "address_purpose": "LOCATION",
            "city": "Detroit Lakes",
            "state": "MN",
            "postal_code": "565012455",
            "country_code": "US",
            "telephone_number": "218-234-5238",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KGOMO",
        "first_name": "SEIPATI",
        "middle_name": "VALERIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-12-20",
        "last_updated": "2024-12-20",
        "certification_date": "2024-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3747P1801X",
            "taxonomy_group": "",
            "desc": "Technician, Personal Care Attendant",
            "state": "MN",
            "license": "3747P1801X",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Personal Care Attendant in Lake Park, MN
• Providers in Lake Park, MN by specialty
• Personal Care Attendant in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 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.