Dale Allen Knudson, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

2743 Issued in CO

Practice address

900 Indiana Ave
Suite # D
Pueblo, CO 81004-3766

Phone

(719) 561-2812

NPI assigned

Aug 27, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Sowash Optometry Group PC

  • Optometrist
  • Lakewood, CO
  • NPI 1336172055
  Medicare reassignment

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

{
    "created_epoch": "1251331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1251331200000",
    "number": "1063645877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "385 W CORAL DR",
            "city": "PUEBLO WEST",
            "state": "CO",
            "postal_code": "810077529",
            "telephone_number": "503-330-6942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 INDIANA AVE",
            "address_2": "SUITE # D",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810043766",
            "telephone_number": "719-561-2812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNUDSON",
        "first_name": "DALE",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-08-27",
        "last_updated": "2009-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CO",
            "license": "2743",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kerri J Knight, RBT
• Debbie Mae Knish, LPN
• Lara Kjurston Knowles, CRNA
• Anthony L Knowlton, DDS
• Rona K Knudsen, MD
• Darren James Kochen
• Athri Kodali, MD
• Colleen Susan Koen, LPN
• Cynthia Echo Koen
• Caroline E Koerner

• Optometrist in Pueblo, CO
• Providers in Pueblo, CO by specialty
• Optometrist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2009; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.