KINGDOM PATHWAYS (NPI# 1851539423) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851539423 |
| Entity Type | Organization |
| Organization Name | KINGDOM PATHWAYS |
| Practice Address |
11825 Bittersweet St Nw Coon Rapids MN 55433-2917 |
| Practice Telephone | 7638625336 |
| Practice Fax Number | 7638625336 |
| Mailing Telephone | 7638625336 |
| Mailing Fax Number | 7638625336 |
| Enumeration Date | 2009-02-04 |
| Last Update Date | 2009-02-04 |
| Authorized Official Name | MR. JAMES MICHAUD (EXEC. DIRECTOR) |
| Authorized Official Telephone | 6513878393 |
| Authorized Official Credential | MDIV. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 253Z00000X | In Home Supportive Care | Agencies |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043848112 | Kingdom Pathways | Clinical Medical Laboratory | 426 Oxford St N, Saint Paul, MN 55104-5080 | 2020-04-01 |
| 1487893046 | Kingdom Pathways | Community/Behavioral Health | 11825 Bittersweet St Nw, Coon Rapids, MN 55433-2917 | 2009-02-05 |
| Street Address |
11825 BITTERSWEET ST NW |
| City | COON RAPIDS |
| State | MN |
| Zip Code | 55433-2917 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487893046 | Kingdom Pathways | Community/Behavioral Health | 11825 Bittersweet St Nw, Coon Rapids, MN 55433-2917 | 2009-02-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770134793 | Shelley Karee Peterson | Technician | 10311 Bittersweet St Nw, Coon Rapids, MN 55433 | 2019-09-20 |
| 1578122057 | Courtney Gau | Behavior Technician | Fraser Coon Rapids, 9120 Springbrook Dr. Nw, Coon Rapids, MN 55433 | 2019-06-10 |
| 1992275606 | Maliki Fofee Kamara | Licensed Practical Nurse | 2451 109th Ave Nw Apt. 1, Coon Rapids, MN 55433 | 2018-11-26 |
| 1992284541 | Sarah Vennes | Massage Therapist | 6400 Flying Cloud Dr, Suite 240, Eden Prairie, MN 55433 | 2018-08-13 |
| 1538646609 | Paige Prince | Behavior Technician | Fraser Coon Rapids, 9120 Springbrook Drive Nw, Coon Rapids, MN 55433 | 2018-07-23 |
| 1154828242 | Karin Lea Englund | Dentist | 9145 Springbrook Dr Nw Ste 100, Coon Rapids, MN 55433 | 2018-04-06 |
| 1235642513 | Vista Family Eye Care LLC | Optometrist | 9920 Foley Blvd Nw Ste 120, Coon Rapids, MN 55433 | 2017-11-09 |
| 1538697818 | Mohammed Nmn Ahmed | Internal Medicine | 9055 Spring Brook Drive, Allina Coon Rapids Clinic 9055, Coon Rapids, MN 55433 | 2017-05-31 |
| 1639531353 | Journi LLC | Nurse Practitioner | 277 Coon Rapids Blvd Suite 308, Coon Rapids, MN 55433 | 2016-03-22 |
| 1821457722 | Honorine Boyce | Licensed Practical Nurse | 2743 111th Ave. Nw, Coon Rapids, MN 55433 | 2016-02-19 |
| Find all providers in zip 55433 | ||||
| Taxonomy Code | 253Z00000X |
| Grouping | Agencies |
| Classification | In Home Supportive Care |
| An In Home Supportive Care Agency provides services in the patient’s home with the goal of enabling the patient to remain at home. The services provided may include personal care services such as hands-on assistance with activities of daily living (ADLs), e.g., eating, bathing, dressing, and bladder and bowel requirements; homemaker services and instrumental activities of daily living (IADLs), e.g., taking medications, shopping for groceries, laundry, housekeeping, and companionship; and/or supervision or cuing so that a person can perform tasks themselves. |
| Notes: Source: National Uniform Claim Committee, 2008 [7/1/2008: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790203800 | Ronette C Miller | In Home Supportive Care | 400 126th Ave Nw, Coon Rapids, MN 55448-1502 | 2017-09-08 |
| 1912564261 | Prosperity Adult Day Services | In Home Supportive Care | 12844 Raven St Nw, Coon Rapids, MN 55448-2578 | 2019-05-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255930137 | Allhealth Home Care LLC | In Home Supportive Care | 23136 Birchwood Estates Rd, Fergus Falls, MN 56537-4516 | 2020-10-21 |
| 1477152593 | Canny, LLC | In Home Supportive Care | 4205 Lancaster Ln N Ste 104, Plymouth, MN 55441-1702 | 2020-10-20 |
| 1164020665 | Seh Morris Brown | In Home Supportive Care | 7655 Woodlawn Dr Apt 305, Saint Paul, MN 55112-4065 | 2020-10-15 |
| 1831797588 | Zarr Blejay Yarpah | In Home Supportive Care | 2508 County Road I Apt 105, Saint Paul, MN 55112-6242 | 2020-10-14 |
| 1538776794 | Dependable Angels Home Care | In Home Supportive Care | 949 Schaller Dr S Ste 2, Maplewood, MN 55119-5843 | 2020-09-30 |
| 1922611011 | Providence Home Care Inc | In Home Supportive Care | 3040 4th Ave S Ste 102, Minneapolis, MN 55408-2409 | 2020-08-28 |
| 1043823545 | Autism Bright Start | In Home Supportive Care | 2644 13th Ave S, Minneapolis, MN 55407-1121 | 2020-08-25 |
| 1174135909 | Amana Care LLC | In Home Supportive Care | 7700 36th Ave N Apt 318, Crystal, MN 55427-2038 | 2020-08-21 |
| 1578175105 | Tracy Denise Winters | In Home Supportive Care | 4404 83rd Cir N, Brooklyn Park, MN 55443-2534 | 2020-08-17 |
| 1811513674 | Lake Country Home Care LLC | In Home Supportive Care | 95 Miller St Ste E, New York Mills, MN 56567-4332 | 2020-06-17 |
| Find all providers with the same taxonomy | ||||
| City | COON RAPIDS |
| Zip Code | 55433 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.