Active NPI
Paul McKnight
- Social Worker
- Metropolis, IL
National Provider Identifier
1063985240
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- Practice address
- 306 W 8TH St
Metropolis, IL 62960-1653 - Phone
- (618) 524-3653
- NPI assigned
- Jan 10, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | Primary |
Addresses
Primary practice location
306 W 8TH St
Metropolis, IL 62960-1653
Mailing address
2259 Pell Rd
Brookport, IL 62910-2306
Phone (618) 638-3717
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 104100000X | Medicaid | IL | |
| PAUL2259 | Medicaid | IL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1547078400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1547078400000",
"number": "1063985240",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2259 PELL RD",
"city": "BROOKPORT",
"state": "IL",
"postal_code": "629102306",
"telephone_number": "618-638-3717"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "306 W 8TH ST",
"city": "METROPOLIS",
"state": "IL",
"postal_code": "629601653",
"telephone_number": "618-524-3653"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCKNIGHT",
"first_name": "PAUL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-01-10",
"last_updated": "2019-01-10",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "104100000X",
"state": "IL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "PAUL2259",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Metropolis, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.