Homer E Knudson, M.D.

Primary specialty

SpecialistTaxonomy code 174400000X

License

23301 Issued in VA

Practice address

8308 Old Courthouse Rd
Suite a
Vienna, VA 22182-3863

Phone

(703) 790-9440

Fax

(703) 790-5359

NPI assigned

Jul 6, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 11

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Frederick Health Hospital Inc

  dba Frederick Health Hospital

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)

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

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1285666891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8308 OLD COURTHOUSE RD",
            "address_2": "SUITE A",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221823863",
            "telephone_number": "703-790-9440",
            "fax_number": "703-790-5359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8308 OLD COURTHOUSE RD",
            "address_2": "SUITE A",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221823863",
            "telephone_number": "703-790-9440",
            "fax_number": "703-790-5359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNUDSON",
        "first_name": "HOMER",
        "middle_name": "E",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "VA",
            "license": "23301",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO",
            "identifier": "0785845",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUESHIELD PPO",
            "identifier": "4087",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE PIN",
            "identifier": "07-00455",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6260730",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GUARDIAN",
            "identifier": "99214",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PPO/HEALTHKEEPERS",
            "identifier": "088399",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTIMUMCHOICE/MAMSI/MDIPA",
            "identifier": "27007",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST PPO/ BLUECHOICE",
            "identifier": "4087",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PPO",
            "identifier": "4087376",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNICARE",
            "identifier": "10316",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA PIN",
            "identifier": "1463350004",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brianna Kleinbrook
• Jan Philip Klinger
• Kelly Klosner, DPT
• Anita D Kloss, DC
• KMB Mental Health Services LLC
• Christopher J Ko, M.D.
• Paige Briann Koenig, ATC
• Elijah Paschall Kohn
• Nandini Koka, MD
• Mostafa Kolahdouzan, DC

• Specialist in Vienna, VA
• Providers in Vienna, VA by specialty
• Specialist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.