Individual provider Active NPI

Kathleen Marie Wright-Knothe, PH.D.

  • Psychologist
  • Fairport, NY
National Provider Identifier
1285737312
Registry record updated May 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
O111421 Issued in NY
Practice address
620 Crosskeys Office Park
Fairport, NY 14450-3508
Phone
(585) 223-5920
Fax
(585) 223-5727
NPI assigned
Sep 6, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X O111421 NY Primary

Addresses

Primary practice location

620 Crosskeys Office Park
Fairport, NY 14450-3508

Mailing address

620 Crosskeys Office Park
Fairport, NY 14450-3508
Phone (585) 223-5920

Other identifiers 4

IdentifierTypeStateIssuer
P010011142OtherNYBLUE CHOICE
100321FCOtherNYPREFERRED CARE
P020011142OtherNYBLUE CROSS BLUE SHIELD
5922621OtherNYAETNA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040116000755 NY Practitioner - Clinical Psychologist 4587565395 Practice locations: Rochester, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

185 Norman Rd
Rochester, NY 14623-1153
Phone (585) 314-0274

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
O111421NYMDPsychologist
011142NYMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1157500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1336694400000",
    "number": "1285737312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 CROSSKEYS OFFICE PARK",
            "city": "FAIRPORT",
            "state": "NY",
            "postal_code": "144503508",
            "telephone_number": "585-223-5920",
            "fax_number": "585-223-5727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 CROSSKEYS OFFICE PARK",
            "city": "FAIRPORT",
            "state": "NY",
            "postal_code": "144503508",
            "telephone_number": "585-223-5920",
            "fax_number": "585-223-5727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WRIGHT-KNOTHE",
        "first_name": "KATHLEEN",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-06",
        "last_updated": "2012-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "O111421",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CHOICE",
            "identifier": "P010011142",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED CARE",
            "identifier": "100321FC",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "P020011142",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5922621",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairport, NY

Sources for this page

Verify at the official NPI Registry.