Aundrea Eliza Knapp

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

Practice address

200 Belle Terre Rd
Port Jefferson, NY 11777-1928

Phone

(631) 474-6000

NPI assigned

Nov 15, 2022

Sex

Female

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1668470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687824000000",
    "number": "1114636461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "269 WALKER AVE",
            "city": "EAST PATCHOGUE",
            "state": "NY",
            "postal_code": "117725519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 BELLE TERRE RD",
            "city": "PORT JEFFERSON",
            "state": "NY",
            "postal_code": "117771928",
            "telephone_number": "631-474-6000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "269 Walker Ave",
            "address_purpose": "LOCATION",
            "city": "East Patchogue",
            "state": "NY",
            "postal_code": "117725519",
            "country_code": "US",
            "telephone_number": "631-987-1607",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KNAPP",
        "first_name": "AUNDREA",
        "middle_name": "ELIZA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-11-15",
        "last_updated": "2023-06-27",
        "certification_date": "2023-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NY",
            "license": null,
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• KK NP in Adult Health LLP
• Robert Klare, PT, CHT
• Joel Kleinberg, MD
• Roger A Kleinman, DDS
• Matthew Klics, PA-C
• Lori-Ann Kneessy
• Gregg Michael Knel
• Ekta Kohli, LCSW
• Alexandros Konstantinidis, DO
• Victoria Kopec, AU.D.

• Athletic Trainer in Port Jefferson, NY
• Providers in Port Jefferson, NY by specialty
• Athletic Trainer in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2023; 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.