NPIMap

Organization Active NPI

McKnight Clinic PLLC

  • Family Medicine Physician
  • Somerville, TN
National Provider Identifier
1043482649
Registry record updated Feb 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
MCKNIGHT CLINIC PLLC
Practice address
25 Woodbridge Rd Ste a
Somerville, TN 38068-1242
Phone
(901) 465-6353
Fax
(833) 902-3599
NPI assigned
Mar 24, 2008
Last updated
Feb 13, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2024

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

Authorized official

Name
Elizabeth P McKnight, FNP-CNPI 1164591566
Title
Partner
Phone
(901) 465-6353

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

25 Woodbridge Rd Ste a
Somerville, TN 38068-1242

Mailing address

25 Woodbridge Rd Ste a
Somerville, TN 38068-1242
Phone (901) 465-6353

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080620000169 TN Part B Supplier - Clinic/Group Practice 9234200130 Receives reassigned benefits from 6 practitioners
Practice locations: Somerville, TN

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
McKnight Clinic2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

25 Woodbridge Rd
Ste A
Somerville, TN 38068
Phone (901) 465-6353

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/26256/brand/1/csg/1/fhir/r4
  • FHIR API: https://fhir-myrecord.cerner.com/r4/110cb3c6-b110-474f-9f37-1dc02438d0c6/

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1206316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707782400000",
    "number": "1043482649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 WOODBRIDGE RD STE A",
            "city": "SOMERVILLE",
            "state": "TN",
            "postal_code": "380681242",
            "telephone_number": "901-465-6353",
            "fax_number": "833-902-3599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 WOODBRIDGE RD STE A",
            "city": "SOMERVILLE",
            "state": "TN",
            "postal_code": "380681242",
            "telephone_number": "901-465-6353",
            "fax_number": "833-902-3599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCKNIGHT CLINIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-24",
        "last_updated": "2024-02-13",
        "certification_date": "2024-02-13",
        "status": "A",
        "authorized_official_last_name": "MCKNIGHT",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "901-465-6353",
        "authorized_official_credential": "FNP-C"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Somerville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.