Individual provider Active NPI

Tony Knight-Jackson

  • Attendant Care Provider
  • Colorado Springs, CO
National Provider Identifier
1104670603
Registry record updated Apr 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Attendant Care ProviderTaxonomy code 3747A0650X
Practice address
3802 Half Turn Rd Apt 108
Colorado Springs, CO 80917-2411
Phone
(719) 306-8092
NPI assigned
Apr 12, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Attendant Care Provider 3747A0650X Primary

Addresses

Primary practice location

3802 Half Turn Rd Apt 108
Colorado Springs, CO 80917-2411

Mailing address

3802 Half Turn Rd Apt 108
Colorado Springs, CO 80917-2411
Phone (719) 306-8092

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": "1712880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712880000000",
    "number": "1104670603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3802 HALF TURN RD APT 108",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809172411",
            "telephone_number": "719-306-8092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3802 HALF TURN RD APT 108",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809172411",
            "telephone_number": "719-306-8092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNIGHT-JACKSON",
        "first_name": "TONY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-04-12",
        "last_updated": "2024-04-12",
        "certification_date": "2024-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3747A0650X",
            "taxonomy_group": "",
            "desc": "Technician, Attendant Care Provider",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2024; 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.