Jack McKnight, PT, DPT

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

62235 Issued in OR

Practice address

19712 Poplar St
Bend, OR 97702-9036

Phone

(951) 537-4424

Fax

(858) 279-5303

NPI assigned

Sep 29, 2015

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• McKnight Physical Therapy

  • Physical Medicine & Rehabilitation Physician
  • Bend, OR
  • NPI 1912704933
  NPD Authorized official

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

{
    "created_epoch": "1443484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711497600000",
    "number": "1104296581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19712 POPLAR ST",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977029036",
            "telephone_number": "951-537-4424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19712 POPLAR ST",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977029036",
            "telephone_number": "951-537-4424",
            "fax_number": "858-279-5303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKNIGHT",
        "first_name": "JACK",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-09-29",
        "last_updated": "2024-03-27",
        "certification_date": "2024-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT 43134",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "OR",
            "license": "62235",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shannon McKewin
• Keith McKie, RPH
• Holly L McKim, OT
• Eric Martin McKinley, MSW
• McKnight Physical Therapy
• Shad Alan McLagan, D.C.
• Alysia Gail McLain, LCSW
• Ian Andrew McLane
• Brian Vincent McLaughlin, MS, NCC
• Katharine Elaine McLaughlin

• Physical Medicine & Rehabilitation Physician in Bend, OR
• Providers in Bend, OR by specialty
• Physical Medicine & Rehabilitation Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 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.