Active NPI
Marshall Knudson, PHD
- Counseling Psychologist
- Gainesville, FL
National Provider Identifier
1164826533
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counseling Psychologist
- License
- 3663
- Practice address
- 2830 NW 41St St
Suite D
Gainesville, FL 32606-6667 - Phone
- (352) 222-2968
- NPI assigned
- Oct 14, 2014
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Counseling Psychologist | 103TC1900X | 3663 | FL | Primary |
Addresses
Primary practice location
2830 NW 41St St
Suite D
Gainesville, FL 32606-6667
Mailing address
2830 NW 41St St
Suite D
Gainesville, FL 32606-6667
Phone (352) 222-2968
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3663 | FL | MD | Counseling Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1413244800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1436054400000",
"number": "1164826533",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2830 NW 41ST ST",
"address_2": "SUITE D",
"city": "GAINESVILLE",
"state": "FL",
"postal_code": "326066667",
"telephone_number": "352-222-2968"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2830 NW 41ST ST",
"address_2": "SUITE D",
"city": "GAINESVILLE",
"state": "FL",
"postal_code": "326066667",
"telephone_number": "352-222-2968"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KNUDSON",
"first_name": "MARSHALL",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-10-14",
"last_updated": "2015-07-05",
"status": "A"
},
"taxonomies": [
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": "FL",
"license": "3663",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gainesville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2015; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.