Individual provider Active NPI

Kodi Stonerock Knott, CRNA

  • Certified Registered Nurse Anesthetist
  • Anchorage, AK
National Provider Identifier
1013640234
Registry record updated Oct 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
195203 Issued in AK
Practice address
2801 Debarr Rd
Anchorage, AK 99508-2932
Phone
(907) 264-9999
NPI assigned
Jul 5, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 13, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Certified Registered Nurse Anesthetist 367500000X 195203 AK Primary

Addresses

Primary practice location

2801 Debarr Rd
Anchorage, AK 99508-2932

Mailing address

2801 Debarr Rd
Anchorage, AK 99508-2932
Phone (907) 276-1131

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220812003027 AK Practitioner - Certified Registered Nurse Anesthetist (Crna) 7810370541 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesia Care Associates PCGroup PAC ID 0446244388, 40 clinicians
Denali Anesthesia LLCGroup PAC ID 2567455678, 25 clinicians

Practice addresses (Care Compare)

2500 S Woodworth Loop
Palmer, AK 99645-8984
Phone (907) 861-6000

2801 Debarr Rd
Anchorage, AK 99508-2932
Phone (907) 276-1257

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
195203AKMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Denali Anesthesia, LLC Nurse Anesthetist, Certified Registered CurrentSince Jul 23, 2022 Accepting new patients

Locations

2801 Debarr Rd
Anchorage, AK 99508
Phone (907) 264-1222

14700 28th Ave N
Ste 20
Plymouth, MN 55447
Phone (612) 559-3779

Organizations & group practices 2

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1656979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665619200000",
    "number": "1013640234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2801 DEBARR RD",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995082932",
            "telephone_number": "907-276-1131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 DEBARR RD",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995082932",
            "telephone_number": "907-264-9999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNOTT",
        "first_name": "KODI",
        "middle_name": "STONEROCK",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-07-05",
        "last_updated": "2022-10-13",
        "certification_date": "2022-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AK",
            "license": "195203",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anchorage, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.