Individual provider Active NPI

Mary Jane Knight

  • Driver
  • Walker, LA
National Provider Identifier
1093090573
Registry record updated Oct 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
DriverTaxonomy code 172A00000X
License
006582267 Issued in LA
Practice address
12447 Fawn Wood Drive
Walker, LA 70785-5754
Phone
(225) 323-3475
Fax
(225) 272-3877
NPI assigned
Oct 17, 2011
Last updated
Oct 17, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Driver 172A00000X 006582267 LA Primary

Addresses

Primary practice location

12447 Fawn Wood Drive
Walker, LA 70785-5754

Mailing address

12447 Fawn Wood Dr
Walker, LA 70785-5754
Phone (225) 323-3475

Other identifiers 1

IdentifierTypeStateIssuer
2161636OtherLAMEDICAID PROVIDER #

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

State licenses

LicenseStateTypeSpecialty
006582267LAMDDriver

Practice roles

OrganizationSpecialtyStatusNew patients
Mary's Transport Service, LLC Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1318809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318809600000",
    "number": "1093090573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12447 FAWN WOOD DR",
            "city": "WALKER",
            "state": "LA",
            "postal_code": "707855754",
            "telephone_number": "225-323-3475",
            "fax_number": "225-271-3877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12447 FAWN WOOD DRIVE",
            "city": "WALKER",
            "state": "LA",
            "postal_code": "707855754",
            "telephone_number": "225-323-3475",
            "fax_number": "225-272-3877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNIGHT",
        "first_name": "MARY",
        "middle_name": "JANE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-17",
        "last_updated": "2011-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172A00000X",
            "taxonomy_group": "",
            "desc": "Driver",
            "state": "LA",
            "license": "006582267",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID PROVIDER #",
            "identifier": "2161636",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Walker, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2011; 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.