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KHOM SYSAVATH
NPI 1316100118
Technician - Personal Care Attendant in Saint Paul, MN

Active since July 02, 2008
23 EMPIRE DRIVE, SUITE 123, SAINT PAUL, MN 55103(651) 222-2787 Get Directions Write a Review

NPPES record last updated: July 2, 2008. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Khom Sysavath NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KHOM SYSAVATH (NPI 1316100118) is an individual personal care attendant in Saint Paul, Minnesota and active in the NPI registry since July 2008.

NPPES Registry Identity

NPI1316100118
Entity TypeIndividualMale
Primary Taxonomy3747P1801X
Provider Legal NameKHOM SYSAVATH
Location Address23 EMPIRE DRIVE, SUITE 123Saint Paul, MN 55103
Mailing Address911 Johnson AvenueWorthington, MN 56187 · (507) 372-5517
Phone(651) 222-2787
Sole ProprietorNo
Enumeration DateJuly 2, 2008
✔ NPI 1316100118 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyTechnician · Personal Care AttendantNursing Service Related Providers
Taxonomy Code3747P1801X
Definition
An individual who provides assistance with eating, bathing, dressing, personal hygiene, activities of daily living as specified in the plan of care. Services which are incidental to the care furnished, or essential to the health and welfare of the individual may also be provided. Personal care providers must meet state defined training and certification standards
23 EMPIRE DRIVE, Saint Paul, MN 55103
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Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CHONG PAO THAO
Technician (Personal Care Attendant)
23 EMPIRE DRIVE, SUITE 123
ST PAUL, MN 55103
Ramsey County (651) 222-2787
PHOTHONG CHOMNARITH
Technician (Personal Care Attendant)
23 EMPIRE DRIVE, SUITE 123
SAINT PAUL, MN 55103
Ramsey County (651) 222-2787
FRANK QUANG
Technician (Personal Care Attendant)
23 EMPIRE DRIVE, SUITE 123
SAINT PAUL, MN 55103
Ramsey County (651) 222-2787

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Khom Sysavath's NPI number?

The NPI number for Khom Sysavath is 1316100118. It was assigned to this individual provider in the NPPES registry on July 2, 2008.

Where is Khom Sysavath located?

Khom Sysavath practices at 23 Empire Drive Suite 123, Saint Paul, MN 55103. The listed phone number is (651) 222-2787.

What is Khom Sysavath's specialty?

The primary specialty registered for this NPI is Technician, specializing in Personal Care Attendant, with taxonomy code 3747P1801X.

When was this NPI record last updated?

The NPPES record for Khom Sysavath was last updated on July 2, 2008. NPI Profile syncs with the weekly NPPES data releases published by CMS.