Active NPI
Debra Leanor McKnight
- Clinical Medical Laboratory
- Burley, ID
National Provider Identifier
1306071410
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Medical Laboratory
- Practice address
- 239 W 13TH St
Burley, ID 83318-1655 - Phone
- (208) 878-2321
- Fax
- (208) 878-9960
- NPI assigned
- May 19, 2009
- Last updated
- May 19, 2009
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Clinical Medical Laboratory | 291U00000X | NU | Primary |
Addresses
Primary practice location
239 W 13TH St
Burley, ID 83318-1655
Mailing address
239 W 13TH St
Burley, ID 83318-1655
Phone (208) 878-2321
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)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mobile Drug Screen | Clinical Medical Laboratory | Past | Accepting new patients |
Organizations & group practices 1
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": "1242691200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1242691200000",
"number": "1306071410",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "239 W 13TH ST",
"city": "BURLEY",
"state": "ID",
"postal_code": "833181655",
"telephone_number": "208-878-2321",
"fax_number": "208-878-9960"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "239 W 13TH ST",
"city": "BURLEY",
"state": "ID",
"postal_code": "833181655",
"telephone_number": "208-878-2321",
"fax_number": "208-878-9960"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCKNIGHT",
"first_name": "DEBRA",
"middle_name": "LEANOR",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-05-19",
"last_updated": "2009-05-19",
"status": "A"
},
"taxonomies": [
{
"code": "291U00000X",
"taxonomy_group": "",
"desc": "Clinical Medical Laboratory",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Burley, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.