Active NPI
Nakita Bernadette Knowles, DPT
- Physical Therapist
- Melbourne, FL
National Provider Identifier
1275917791
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 29139
- Practice address
- 4001 Stack Blvd
Melbourne, FL 32901-8500 - Phone
- (321) 499-4690
- NPI assigned
- Jul 14, 2015
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 9773 | TN | |
| Physical Therapist | 225100000X | 29139 | FL | Primary |
Addresses
Primary practice location
4001 Stack Blvd
Melbourne, FL 32901-8500
Mailing address
4001 Stack Blvd
Melbourne, FL 32901-8500
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
| License | State | Type | Specialty |
|---|---|---|---|
| 29139 | FL | MD | Physical Therapist |
| 9773 | TN | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1436832000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1453334400000",
"number": "1275917791",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4001 STACK BLVD",
"city": "MELBOURNE",
"state": "FL",
"postal_code": "329018500"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4001 STACK BLVD",
"city": "MELBOURNE",
"state": "FL",
"postal_code": "329018500",
"telephone_number": "321-499-4690"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KNOWLES",
"first_name": "NAKITA",
"middle_name": "BERNADETTE",
"name_prefix": "Dr.",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-07-14",
"last_updated": "2016-01-21",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "TN",
"license": "9773",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "FL",
"license": "29139",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Melbourne, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.