Active NPI
Sandra L Knudson, PT
- Specialist
- Grand Forks, ND
National Provider Identifier
1255478632
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 0227
- Practice address
- 1000 South Columbia Road
Grand Forks, ND 58206-6002 - Phone
- (701) 780-5000
- NPI assigned
- Feb 1, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 227 | ND | |
| Specialist | 174400000X | 0227 | ND | Primary |
Addresses
Primary practice location
1000 South Columbia Road
Grand Forks, ND 58206-6002
Mailing address
PO Box 6002
Grand Forks, ND 58206-6002
Phone (701) 780-5000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 58557 | Medicaid | ND |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 227 | ND | MD | Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Clinic Pharmacy Inc | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Community/Retail Pharmacy
- Devils Lake, ND
- NPI 1184718876
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170288000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1311292800000",
"number": "1255478632",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 6002",
"city": "GRAND FORKS",
"state": "ND",
"postal_code": "582066002",
"telephone_number": "701-780-5000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1000 SOUTH COLUMBIA ROAD",
"city": "GRAND FORKS",
"state": "ND",
"postal_code": "582066002",
"telephone_number": "701-780-5000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KNUDSON",
"first_name": "SANDRA",
"middle_name": "L",
"name_prefix": "Mrs.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-01",
"last_updated": "2011-07-22",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "ND",
"license": "227",
"primary": false
},
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "ND",
"license": "0227",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "58557",
"state": "ND"
}
],
"endpoints": [],
"other_names": []
}Other providers in Grand Forks, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.