Individual provider Active NPI

Colin G Knight, M.D.

  • Pediatric Surgery Physician
  • Fort Pierce, FL
National Provider Identifier
1285836718
Registry record updated Dec 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Surgery PhysicianTaxonomy code 2086S0120X
License
ME-99402 Issued in FL
Practice address
2402 Frist Blvd Ste 204
Fort Pierce, FL 34950-4838
Phone
(772) 462-3939
Fax
(772) 462-3938
NPI assigned
Jun 5, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Surgery Physician 2086S0120X ME-99402 FL Primary

Addresses

Primary practice location

2402 Frist Blvd Ste 204
Fort Pierce, FL 34950-4838

Mailing address

11760 SW 40TH St Ste 722
Miami, FL 33175-8101
Phone (305) 559-1334

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190301000849 FL Practitioner - General SurgeryPractitioner - Pediatric Medicine 8820224322 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME-99402FLMDPediatric Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lawnwood Healthcare Specialists LLC CurrentSince Mar 1, 2019 Accepting new patients
Miami Associates in Pediatric Surgery PA PastSince Jan 1, 2022 Accepting new patients
Nicklaus Children'S Pediatric Specialists, LLC PastSince Jan 1, 2022 Accepting new patients

Locations

2402 Frist Blvd
Ste 204
Fort Pierce, FL 34950
Phone (772) 466-1113

11750 SW 40th St
Miami, FL 33175
Phone (305) 227-5544

11760 SW 40th St
Ste 722
Miami, FL 33175
Phone (305) 559-1883

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/9d02172d-d861-4f2f-87b5-3b1c5ad61f32/
  • Direct secure messaging: colin.knight@hca4.eclinicaldirectplus.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1181001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703116800000",
    "number": "1285836718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11760 SW 40TH ST STE 722",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331758101",
            "telephone_number": "305-559-1334",
            "fax_number": "305-559-3168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2402 FRIST BLVD STE 204",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349504838",
            "telephone_number": "772-462-3939",
            "fax_number": "772-462-3938"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNIGHT",
        "first_name": "COLIN",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-05",
        "last_updated": "2023-12-21",
        "certification_date": "2023-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0120X",
            "taxonomy_group": "",
            "desc": "Surgery, Pediatric Surgery",
            "state": "FL",
            "license": "ME-99402",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Pierce, FL

Sources for this page

Verify at the official NPI Registry.