KOA HEALTH PLLC
NPI 1508543919
Nurse Practitioner - Family in Ham Lake, MN
About Koa Health Pllc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KOA HEALTH PLLC (NPI 1508543919) is a healthcare organization registered as a family in Ham Lake, Minnesota and active in the NPI registry since June 2023. The organization holds a CLIA Waiver certificate valid through November 12, 2027 and lists Rebecca Brittain, Nurse Practitioner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 24D2293606
Koa Health PLLC · Ham Lake, MNOther Providers at the Same Location NPPES
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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 Koa Health PLLC's NPI number?
The NPI number for Koa Health PLLC is 1508543919. It was assigned to this organization in the NPPES registry on June 28, 2023.
Where is Koa Health PLLC located?
Koa Health PLLC is located at 3120 142nd Ave NE, Ham Lake, MN 55304. The listed phone number is (701) 330-5573.
What is Koa Health PLLC's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Does Koa Health PLLC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 24D2293606) is associated with this NPI, valid through November 12, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Koa Health PLLC was last updated on June 28, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Koa Health Pllc · NPI 1508543919
Family organization in Ham Lake, Minnesota. Organization record, active in the CMS NPPES registry since June 28, 2023.
## Identity
- **NPI:** 1508543919 (Entity type: Organization)
- **Enumerated:** June 28, 2023
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **Organization subpart:** No
- **Authorized official:** Rebecca Brittain, NURSE PRACTITIONER
## Practice location
- **Address:** 3120 142ND AVE NE, Ham Lake, MN 55304-6842
- **Phone:** (701) 330-5573
## Record status
- **NPPES last updated:** June 28, 2023
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1508543919) · Data from the CMS NPPES public registry.