Individual provider Active NPI

John Clifford Knight, PHYSICIANS ASSISTANT

  • Medical Physician Assistant
  • Cross City, FL
National Provider Identifier
1285694158
Registry record updated May 21, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA1733 Issued in FL
Practice address
149 NE 241 St
Cross City, FL 32628-3305
Phone
(352) 498-1360
Fax
(352) 498-1363
NPI assigned
Mar 24, 2006
Last updated
May 21, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA1733 FL Primary

Addresses

Primary practice location

149 NE 241 St
Cross City, FL 32628-3305

Mailing address

149 NE 241 St
Cross City, FL 32628-3305
Phone (352) 498-1360

Other identifiers 1

IdentifierTypeStateIssuer
290243500MedicaidFL

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
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA1733FLMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Department of Health PastSince Jul 29, 2005 Accepting new patients
Florida Clinical Practice Association Inc Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1143158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211328000000",
    "number": "1285694158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "149 NE 241 ST",
            "city": "CROSS CITY",
            "state": "FL",
            "postal_code": "326283305",
            "telephone_number": "352-498-1360",
            "fax_number": "352-498-1363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "149 NE 241 ST",
            "city": "CROSS CITY",
            "state": "FL",
            "postal_code": "326283305",
            "telephone_number": "352-498-1360",
            "fax_number": "352-498-1363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNIGHT",
        "first_name": "JOHN",
        "middle_name": "CLIFFORD",
        "name_prefix": "Mr.",
        "credential": "PHYSICIANS ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-24",
        "last_updated": "2008-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA1733",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "290243500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cross City, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2008; 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.