Active NPI
Phillip W Knod, CRNA
- Anesthesiology Physician
- Little Rock, AR
National Provider Identifier
1205925757
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- C00631
- Practice address
- 9601 Interstate 630 Exit 7
Little Rock, AR 72205-7202 - Phone
- (501) 202-2093
- NPI assigned
- Oct 12, 2006
- 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 |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | C00631 | AR | Primary |
Addresses
Primary practice location
9601 Interstate 630 Exit 7
Little Rock, AR 72205-7202
Mailing address
11001 Executive Center Dr
Suite 200
Little Rock, AR 72211-4316
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 139140701 | Medicaid | AR |
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)
- Enrolled
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C00631 | AR | MD | Anesthesiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Baptist Medcare, Inc | Past | Accepting new patients | |
| Arkansas Health Group | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Family Medicine Physician
- Sheridan, AR
- NPI 1548239247
-
- Emergency Medicine Physician
- Little Rock, AR
- NPI 1699868323
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160611200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1210896000000",
"number": "1205925757",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11001 EXECUTIVE CENTER DR",
"address_2": "SUITE 200",
"city": "LITTLE ROCK",
"state": "AR",
"postal_code": "722114316"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9601 INTERSTATE 630 EXIT 7",
"city": "LITTLE ROCK",
"state": "AR",
"postal_code": "722057202",
"telephone_number": "501-202-2093"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KNOD",
"first_name": "PHILLIP",
"middle_name": "W",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-12",
"last_updated": "2008-05-16",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "AR",
"license": "C00631",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "139140701",
"state": "AR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Little Rock, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.