Thomas John Knutson, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

53686 Issued in AZ

Practice address

11851 N 51St Ave
Glendale, AZ 85304-2809

Phone

(480) 882-4545

Fax

(480) 882-5814

NPI assigned

May 26, 2011

Sex

Male

Sole proprietor

Yes

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• North Central Missouri Mental Health Center

  • Community/Behavioral Health Agency
  • Trenton, MO
  • NPI 1730258930

  MO, Psychiatry

  Medicare reassignment Care Compare group NPD
• Sierra Vista Regional Health Center Medical Group LLC

  • Family Medicine Physician
  • Sierra Vista, AZ
  • NPI 1043575483

  AZ, Family Medicine

  Medicare reassignment NPD
• Alivation Health, LLC

  • Psychiatry Physician
  • Lincoln, NE
  • NPI 1710917448

  Family Medicine, NE

  Medicare reassignment NPD
• Community Renewal Team, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Hartford, CT
  • NPI 1841301876

  CT

  Medicare reassignment NPD
• Serenity TMS Centers LLC

  • Psychiatry Physician
  • Lehi, UT
  • NPI 1710492095

  Psychiatry, UT

  Medicare reassignment NPD
• North Central Missouri Mental Health Center

  • Community/Behavioral Health Agency
  • Trenton, MO
  • NPI 1154863306
  NPD

Specialty

Psychiatry

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

North Central Missouri Mental Health Center 13 clinicians

Practice addresses (Care Compare)

Medicare fee-for-service enrollment

Enrolled in MO, CT, AZ, NE, UT5 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 5

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

Practice roles (6 of 12)

Locations

Networks

• devoted network organization-27eb9117-6975-449a-a7ad-909243995ddc
• devoted network organization-2b183dd2-4e80-4977-80a6-4fdf0df4361d
• IA HMO
• IL PPO Downstate
• devoted network organization-734447cc-691b-4aa7-a112-9c9c8698dcc9
• IA HMO C-SNP

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

Specialties & licenses 3

Addresses

Other identifiers 1

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

{
    "created_epoch": "1306368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669852800000",
    "number": "1003109745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7500 N DREAMY DRAW DR STE 145",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850204668",
            "telephone_number": "480-882-4545",
            "fax_number": "480-882-5814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11851 N 51ST AVE",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853042809",
            "telephone_number": "480-882-4545",
            "fax_number": "480-882-5814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNUTSON",
        "first_name": "THOMAS",
        "middle_name": "JOHN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-05-26",
        "last_updated": "2022-12-01",
        "certification_date": "2022-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MS",
            "license": "25255",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MO",
            "license": "2022025738",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "AZ",
            "license": "53686",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "151850",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kimberly Knight, PTA
• Nancy Lee Knobloch, RN
• Sharan Kaur Knott
• Dawn S Knudsen, PHARM.D.
• Sharon Knudson, LAC
• Kristina Koan, RN
• Ashley Renee Kobold
• Elisa Ann Koch, DPT
• Lakshmi Vilasitha Kocherlakota, MD
• Cyenthia Louise Koehler, MD

• All providers in Glendale, AZ
• Psychiatry Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.