Pamela Rose Knickerbocker, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

OS19486 Issued in FL

Practice address

1006 W Pleasant St
Avon Park, FL 33825-2966

Phone

(863) 453-3121

Fax

(863) 452-2823

NPI assigned

Feb 5, 2007

Last updated

Feb 16, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Pamela Rose Garner Former name

Medicare fee-for-service enrollment

Enrolled in CA, FL2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Family Practice

Education

Oklahoma State University College of Osteopathic Medicine, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Adventist Health System-Sunbelt IncGroup PAC ID 0749232445, 100 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Centerwell Home Health Home health agency, Winter Haven, FL, CCN 107534
• Adventhealth Sebring Hospital, Sebring, FL, CCN 100109

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: pknickerbocker1030647@adventhealth.direct-ci.com

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.

• Adventist Health System-Sunbelt Inc

  dba AdventHealth Cancer Institute Sebring

  • General Acute Care Hospital
  • Sebring, FL
  • NPI 1083692594
  Medicare reassignment Care Compare group NPD
• Dignity Health

  dba Dignity Health Mercy Oncology Center

  • Oncology Clinic/Center
  • Redding, CA
  • NPI 1336588870
  Medicare reassignment NPD
• Shasta Community Health Center

  dba Shasta Community Telemedicine and Training Center

  • Federally Qualified Health Center (FQHC)
  • Redding, CA
  • NPI 1114533171
  Medicare reassignment NPD
• Adventist Health System-Sunbelt Inc

  dba Adventhealth Family and Lifestyle Medicine Avon Park

  • Rural Health Clinic/Center
  • Avon Park, FL
  • NPI 1881850956

  Family Medicine

  NPD
• Dignity Health

  dba Mercy Medical Center Redding

  • General Acute Care Hospital
  • Redding, CA
  • NPI 1477671535
  NPD
• Shasta Community Health Center

  dba Shasta Community Health Center Urgent Care

  • Federally Qualified Health Center (FQHC)
  • Redding, CA
  • NPI 1356815542
  NPD
• Shasta Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Redding, CA
  • NPI 1891710638

  Family Medicine

  NPD
• Adventist Health System-Sunbelt Inc

  dba AdventHealth Medical Group Breast Surgery, Ear Nose & Throat, General Surgery at Sun N Lake

  • Internal Medicine Physician
  • Sebring, FL
  • NPI 1164698809

  Family Medicine

  NPD (past)
• Adventist Health System-Sunbelt Inc

  dba AdventHealth Family Medicine Wauchula

  • Rural Health Clinic/Center
  • Wauchula, FL
  • NPI 1396046637

  Family Medicine

  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Adventist Health System-Sunbelt Inc

  dba AdventHealth Cancer Institute Sebring

  • General Acute Care Hospital
  • Sebring, FL
  • NPI 1083692594
  Care Compare affiliation
• Senior Home Care, Inc.

  dba Centerwell Home Health

  • Home Health Agency
  • Winter Haven, FL
  • NPI 1235180274
  Care Compare affiliation
• Senior Home Care, Inc.

  dba Centerwell Home Health

  • Home Health Agency
  • Lake Mary, FL
  • NPI 1679524615
  Care Compare affiliation

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

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676505600000",
    "number": "1164561353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1035 PLACER ST",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960011125",
            "telephone_number": "530-246-5710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1006 W PLEASANT ST",
            "city": "AVON PARK",
            "state": "FL",
            "postal_code": "338252966",
            "telephone_number": "863-453-3121",
            "fax_number": "863-452-2823"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4215 Front St",
            "address_purpose": "LOCATION",
            "city": "Shasta Lake",
            "state": "CA",
            "postal_code": "960199430",
            "country_code": "US",
            "telephone_number": "530-246-5896",
            "fax_number": "530-246-5787",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KNICKERBOCKER",
        "first_name": "PAMELA",
        "middle_name": "ROSE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-05",
        "last_updated": "2023-02-16",
        "certification_date": "2023-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A2012777",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS19486",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "4409",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PAMELA",
            "last_name": "GARNER",
            "middle_name": "ROSE",
            "credential": "D.O.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Michael Ray Karr, PA-C
• Victoria Frances Kennedy, PTA
• Khurana Family Medicine M.D., P.a.
• Sunaina Khurana, MD
• Brittany Lee-Ann King, PA-C
• J. Agustin Lacson, M.D.
• Arleen Ann Lally, D.O.
• Long Lam, PHARMD
• Ashlynne Feely Langford, APRN, CPNP-PC
• Patrick Dennis Lavallie

• Family Medicine Physician in Avon Park, FL
• Providers in Avon Park, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.