S J Knackstedt Inc

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

144 Issued in NM

Legal business name

S J KNACKSTEDT INC

Practice address

4516 Altura Place NE
Albuquerque, NM 87110-5706

Phone

(505) 265-3959

Fax

(505) 262-9222

NPI assigned

Jan 8, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Steve Jay Knackstedt, OT

Title

President

Phone

(505) 265-3959

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1023166501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4516 ALTURA PLACE NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871105706",
            "telephone_number": "505-265-3959",
            "fax_number": "505-262-9222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4516 ALTURA PLACE NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871105706",
            "telephone_number": "505-265-3959",
            "fax_number": "505-262-9222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "S J KNACKSTEDT INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KNACKSTEDT",
        "authorized_official_first_name": "STEVE",
        "authorized_official_middle_name": "JAY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "505-265-3959",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "OT"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist",
            "state": "NM",
            "license": "144",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "D4185",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Occupational Therapist in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Occupational Therapist in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.