Active NPI
Russell Knop
- Addiction (Substance Use Disorder) Counselor
- Roxboro, NC
National Provider Identifier
1316048960
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 1005
- Practice address
- 355 S Madison Blvd Ste C
Roxboro, NC 27573-5485 - Phone
- (336) 599-8366
- Fax
- (336) 597-2404
- NPI assigned
- Sep 26, 2006
- Last updated
- Feb 20, 2008
- 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 |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 1005 | NC | Primary |
Addresses
Primary practice location
355 S Madison Blvd Ste C
Roxboro, NC 27573-5485
Mailing address
6015 Fayetteville Rd
Suite 211
Durham, NC 27713-6254
Phone (919) 572-0001
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1005 | NC | MD | Acupuncturist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159228800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1203465600000",
"number": "1316048960",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6015 FAYETTEVILLE RD",
"address_2": "SUITE 211",
"city": "DURHAM",
"state": "NC",
"postal_code": "277136254",
"telephone_number": "919-572-0001",
"fax_number": "919-572-0004"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "355 S MADISON BLVD STE C",
"city": "ROXBORO",
"state": "NC",
"postal_code": "275735485",
"telephone_number": "336-599-8366",
"fax_number": "336-597-2404"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KNOP",
"first_name": "RUSSELL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-26",
"last_updated": "2008-02-20",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "NC",
"license": "1005",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Roxboro, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.