Individual provider Active NPI

Roger Tolman Knighton Jr., M.N.S. CCC-A

  • Audiologist
  • Tempe, AZ
National Provider Identifier
1295908168
Registry record updated Apr 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
DA1303 Issued in AZ
Practice address
2600 E Southern Ave
Ste J2
Tempe, AZ 85282-7610
Phone
(480) 969-3775
NPI assigned
Apr 10, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 10, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X DA1303 AZ Primary

Addresses

Primary practice location

2600 E Southern Ave
Ste J2
Tempe, AZ 85282-7610

Mailing address

613 W Comstock Dr
Gilbert, AZ 85233-5805
Phone (480) 969-3775

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150112002317 AZ Practitioner - Qualified Audiologist 8426372814 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 1993
Medicare assignment
May accept Medicare assignment
Group practices
Fynes Audiology LLCGroup PAC ID 0749173318, 2 clinicians

Practice addresses (Care Compare)

2058 S Dobson Rd
Suite 9
Mesa, AZ 85202-6455
Phone (480) 456-0176

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Fynes Audiology LLC CurrentSince Jan 1, 2016 Accepting new patients
Desert Valley ENT, PC CurrentSince Sep 1, 2014 Accepting new patients
Valley ENT, PC Past Accepting new patients

Locations

2680 S Val Vista Dr
Ste 175
Gilbert, AZ 85295
Phone (480) 784-0110

2058 S Dobson Rd
Ste 9
Mesa, AZ 85202
Phone (480) 456-0176

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": "1207785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207785600000",
    "number": "1295908168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "613 W COMSTOCK DR",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852335805",
            "telephone_number": "480-969-3775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 E SOUTHERN AVE",
            "address_2": "STE J2",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852827610",
            "telephone_number": "480-969-3775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNIGHTON",
        "first_name": "ROGER",
        "middle_name": "TOLMAN",
        "name_suffix": "Jr.",
        "credential": "M.N.S. CCC-A",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-04-10",
        "last_updated": "2008-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "AZ",
            "license": "DA1303",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tempe, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.