Individual provider Active NPI

Braun Knutson, CERTIFIED PEER SUPP

  • Peer Specialist
  • Bismarck, ND
National Provider Identifier
1245950807
Registry record updated Sep 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Peer SpecialistTaxonomy code 175T00000X
License
249 Issued in ND
Practice address
101 East Broadway Avenue
Bismarck, ND 58501
Phone
(701) 222-0386
Fax
(701) 255-4891
NPI assigned
Sep 1, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Peer Specialist 175T00000X 249 ND Primary

Addresses

Primary practice location

101 East Broadway Avenue
Bismarck, ND 58501

Mailing address

101 East Broadway Avenue
Bismarck, ND 58501
Phone (701) 222-0386

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

LicenseStateTypeSpecialty
249NDMDPeer Specialist

NPI Registry JSON

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

{
    "created_epoch": "1661990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662422400000",
    "number": "1245950807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 EAST BROADWAY AVENUE",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "58501",
            "telephone_number": "701-222-0386",
            "fax_number": "701-255-4891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 EAST BROADWAY AVENUE",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "58501",
            "telephone_number": "701-222-0386",
            "fax_number": "701-255-4891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNUTSON",
        "first_name": "BRAUN",
        "credential": "CERTIFIED PEER SUPP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-09-01",
        "last_updated": "2022-09-06",
        "certification_date": "2022-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "ND",
            "license": "249",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bismarck, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.