Active NPI
Roger McKnight
- Peer Specialist
- Denton, MD
National Provider Identifier
1184409864
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Peer Specialist
- License
- PR0563
- Practice address
- 18 Denton PLZ
Denton, MD 21629-9501 - Phone
- (667) 292-0335
- NPI assigned
- Aug 30, 2023
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Peer Specialist | 175T00000X | PR0563 | MD | Primary |
Addresses
Primary practice location
18 Denton PLZ
Denton, MD 21629-9501
Mailing address
18 Denton PLZ
Denton, MD 21629-9501
Phone (667) 292-0335
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PR0563 | Other | MD | STATE CERTIFICATION |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PR0563 | MD | MD | Peer Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1693353600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1693353600000",
"number": "1184409864",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18 DENTON PLZ",
"city": "DENTON",
"state": "MD",
"postal_code": "216299501",
"telephone_number": "667-292-0335"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18 DENTON PLZ",
"city": "DENTON",
"state": "MD",
"postal_code": "216299501",
"telephone_number": "667-292-0335"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCKNIGHT",
"first_name": "ROGER",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-08-30",
"last_updated": "2023-08-30",
"certification_date": "2023-08-30",
"status": "A"
},
"taxonomies": [
{
"code": "175T00000X",
"taxonomy_group": "",
"desc": "Peer Specialist",
"state": "MD",
"license": "PR0563",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE CERTIFICATION",
"identifier": "PR0563",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}Other providers in Denton, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 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.