Active NPI
Douglas James McKnight, D.D.S.
- Dentist
- Plattsmouth, NE
National Provider Identifier
1073684999
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 6540
- Practice address
- 2302 8TH Ave
Suite 2
Plattsmouth, NE 68048-2365 - Phone
- (402) 296-2818
- Fax
- (402) 296-2510
- NPI assigned
- Nov 13, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Dentist | 122300000X | 6540 | NE | Primary |
Addresses
Primary practice location
2302 8TH Ave
Suite 2
Plattsmouth, NE 68048-2365
Mailing address
2302 8TH Ave
Suite 2
Plattsmouth, NE 68048-2365
Phone (402) 296-2818
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 10025261200 | Medicaid | NE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NE
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20161109000206 | NE | Order and Referring Only - Oral Surgery | 9234418526 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6540 | NE | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163376000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1073684999",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2302 8TH AVE",
"address_2": "SUITE 2",
"city": "PLATTSMOUTH",
"state": "NE",
"postal_code": "680482365",
"telephone_number": "402-296-2818",
"fax_number": "402-296-2510"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2302 8TH AVE",
"address_2": "SUITE 2",
"city": "PLATTSMOUTH",
"state": "NE",
"postal_code": "680482365",
"telephone_number": "402-296-2818",
"fax_number": "402-296-2510"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCKNIGHT",
"first_name": "DOUGLAS",
"middle_name": "JAMES",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-11-13",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NE",
"license": "6540",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "10025261200",
"state": "NE"
}
],
"endpoints": [],
"other_names": []
}Other providers in Plattsmouth, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.