Molly Lynn Knickerbocker, CRNP

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

1-144954 Issued in AL

Practice address

1860 Shellbrook Dr NW
Huntsville, AL 35806-3414

Phone

(256) 541-3868

NPI assigned

Jan 28, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• HH Digestive Disease Center

  • Gastroenterology Physician
  • Huntsville, AL
  • NPI 1760896856
  Medicare reassignment NPD

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

{
    "created_epoch": "1643328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643328000000",
    "number": "1194478297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1860 SHELLBROOK DR NW",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358063414",
            "telephone_number": "256-541-3868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1860 SHELLBROOK DR NW",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358063414",
            "telephone_number": "256-541-3868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNICKERBOCKER",
        "first_name": "MOLLY",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "CRNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-01-28",
        "last_updated": "2022-01-28",
        "certification_date": "2022-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "AL",
            "license": "1-144954",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julia Minopoli Klug, PA-C
• Shaile Klugiewicz
• Ellen M Knapp, LPC, LMHC
• William Knapp
• Madaline Rose Knaupp, LCSW, CADC, CTP
• Knight Chiropractic Center, LLC
• Camiya Denise Knight
• Casey Jane Knight
• Danella Charmein Knight, PSY.D.
• Derrick Knight, MS

• Acute Care Nurse Practitioner in Huntsville, AL
• Providers in Huntsville, AL by specialty
• Acute Care Nurse Practitioner in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2022; 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.

Verify at the official NPI Registry.