Individual provider Active NPI

William E. C. Knobeloch, MD

  • Pediatrics Physician
  • Westerville, OH
National Provider Identifier
1225064702
Registry record updated Nov 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
35.077057 Issued in OH
Practice address
540 N Cleveland Ave Ste 200
Westerville, OH 43082-9845
Phone
(614) 891-9505
Fax
(614) 891-6416
NPI assigned
Jun 24, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 1, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 35.077057 OH Primary

Addresses

Primary practice location

540 N Cleveland Ave Ste 200
Westerville, OH 43082-9845

Mailing address

540 N Cleveland Ave Ste 200
Westerville, OH 43082-9845
Phone (614) 891-9505

Other identifiers 1

IdentifierTypeStateIssuer
2234675MedicaidOH

Other names 1

  • William Edwin Cullen Knobeloch Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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 1

Enrollment IDStateProvider typePAC IDDetails
I20211122001761 OH Practitioner - Pediatric Medicine 9830588342 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Central Ohio Primary Care Physicians Inc Current Accepting new patients
Central Ohio Primary Care Physicians, Inc. CurrentSince Nov 1, 2021 Accepting new patients
Central Ohio Primary Care Physicians, Inc. Pediatrics CurrentSince Nov 1, 2021 Accepting new patients

Locations

4885 Olentangy River Rd
Columbus, OH 43214
Phone (614) 326-5665

1920 Tamarack Rd
Newark, OH 43055
Phone (614) 755-5151

540 N Cleveland Ave
Ste 250
Westerville, OH 43082
Phone (614) 891-4705

540 N Cleveland Ave
Ste 200
Westerville, OH 43082
Phone (614) 891-9505

655 Africa Rd
Westerville, OH 43082

Interoperability endpoints

  • Direct secure messaging: wknobeloch19115@copcp.medicity.net

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1151107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635724800000",
    "number": "1225064702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "540 N CLEVELAND AVE STE 200",
            "city": "WESTERVILLE",
            "state": "OH",
            "postal_code": "430829845",
            "telephone_number": "614-891-9505",
            "fax_number": "614-891-6416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 N CLEVELAND AVE STE 200",
            "city": "WESTERVILLE",
            "state": "OH",
            "postal_code": "430829845",
            "telephone_number": "614-891-9505",
            "fax_number": "614-891-6416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNOBELOCH",
        "first_name": "WILLIAM",
        "middle_name": "E. C.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-24",
        "last_updated": "2021-11-01",
        "certification_date": "2021-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "35.077057",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2234675",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "WILLIAM",
            "last_name": "KNOBELOCH",
            "middle_name": "EDWIN CULLEN",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Westerville, OH

Sources for this page

Verify at the official NPI Registry.