Active NPI
Jeanette M Knill, PT
- Physical Therapist
- Green Bay, WI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 12077--24
- Practice address
- 720 S Vanburen St
Green Bay, WI 54230-3504 - Phone
- (920) 468-3444
- Fax
- (920) 432-6313
- NPI assigned
- Mar 20, 2007
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 12077--24 | WI | Primary |
Addresses
Primary practice location
720 S Vanburen St
Green Bay, WI 54230-3504
Mailing address
PO Box 22487
Green Bay, WI 54305-2487
Phone (920) 445-7222
Other practice location 1
2641 Development Dr
Green Bay, WI 54311-4240
Phone (920) 338-6868
Other practice location 2
744 S Webster Ave
Green Bay, WI 54301-3505
Phone (920) 433-7822
Other practice location 3
2820 Roosevelt Rd
Marinette, WI 54143-3834
Phone (715) 735-5225
Other practice location 4
725 S Webster Ave
Neuro Team
Green Bay, WI 54301-3500
Phone (920) 433-7995
Other practice location 5
704 S Webster Ave
Green Bay, WI 54301-3528
Phone (920) 433-3410
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 767190 | Other | IL | MEDICARE GROUP ID # |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12077--24 | WI | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bellin Memorial Hospital Inc | 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 and National Provider Directory roles.
-
- Family Medicine Physician
- Brillion, WI
- NPI 1962464784
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174348800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1595548800000",
"number": "1104941772",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 22487",
"city": "GREEN BAY",
"state": "WI",
"postal_code": "543052487",
"telephone_number": "920-445-7222",
"fax_number": "920-445-7289"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "720 S VANBUREN ST",
"city": "GREEN BAY",
"state": "WI",
"postal_code": "542303504",
"telephone_number": "920-468-3444",
"fax_number": "920-432-6313"
}
],
"practiceLocations": [
{
"address_1": "2641 Development Dr",
"address_purpose": "LOCATION",
"city": "Green Bay",
"state": "WI",
"postal_code": "543114240",
"country_code": "US",
"telephone_number": "920-338-6868",
"fax_number": "920-338-6859",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "744 S Webster Ave",
"address_purpose": "LOCATION",
"city": "Green Bay",
"state": "WI",
"postal_code": "543013505",
"country_code": "US",
"telephone_number": "920-433-7822",
"fax_number": "920-433-3651",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2820 Roosevelt Rd",
"address_purpose": "LOCATION",
"city": "Marinette",
"state": "WI",
"postal_code": "541433834",
"country_code": "US",
"telephone_number": "715-735-5225",
"fax_number": "715-735-5388",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "725 S Webster Ave",
"address_2": "Neuro Team",
"address_purpose": "LOCATION",
"city": "Green Bay",
"state": "WI",
"postal_code": "543013500",
"country_code": "US",
"telephone_number": "920-433-7995",
"fax_number": "920-433-3458",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "704 S Webster Ave",
"address_purpose": "LOCATION",
"city": "Green Bay",
"state": "WI",
"postal_code": "543013528",
"country_code": "US",
"telephone_number": "920-433-3410",
"fax_number": "920-433-3419",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KNILL",
"first_name": "JEANETTE",
"middle_name": "M",
"name_prefix": "Ms.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-20",
"last_updated": "2020-07-24",
"certification_date": "2020-07-24",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WI",
"license": "12077--24",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE GROUP ID #",
"identifier": "767190",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Green Bay, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.