Active NPI
Brent Knutson, DC
- Chiropractor
- Jacksonville, FL
National Provider Identifier
1295467967
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- CH14133
- Practice address
- 3546 Saint Johns Bluff Rd S Unit 204
Jacksonville, FL 32224-2716 - Phone
- (904) 996-2243
- NPI assigned
- Jun 30, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | CH14133 | FL | Primary |
Addresses
Primary practice location
3546 Saint Johns Bluff Rd S Unit 204
Jacksonville, FL 32224-2716
Mailing address
3546 Saint Johns Bluff Rd S Unit 204
Jacksonville, FL 32224-2716
Phone (904) 996-2243
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220816000666 | FL | Practitioner - Chiropractic | 2163805615 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CH14133 | FL | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1656547200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1656547200000",
"number": "1295467967",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3546 SAINT JOHNS BLUFF RD S UNIT 204",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322242716",
"telephone_number": "904-996-2243"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3546 SAINT JOHNS BLUFF RD S UNIT 204",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322242716",
"telephone_number": "904-996-2243"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KNUTSON",
"first_name": "BRENT",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-06-30",
"last_updated": "2022-06-30",
"certification_date": "2022-06-30",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "FL",
"license": "CH14133",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jacksonville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.