Whitney Maryruth Knoop, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APRN.CNP.18684 Issued in OH

Practice address

1540 Michigan St
Sidney, OH 45365-2451

Phone

(937) 492-1961

Fax

(937) 492-1962

NPI assigned

Jan 15, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Whitney Maryruth Duncanson-Pedevilla Former name

Medicare fee-for-service enrollment

Enrolled in IN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Pic Indiana PC

  • Urgent Care Clinic/Center
  • Mishawaka, IN
  • NPI 1942546890
  Medicare reassignment NPD

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

{
    "created_epoch": "1452816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620604800000",
    "number": "1316304777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1540 MICHIGAN ST",
            "city": "SIDNEY",
            "state": "OH",
            "postal_code": "453652451",
            "telephone_number": "937-492-1962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1540 MICHIGAN ST",
            "city": "SIDNEY",
            "state": "OH",
            "postal_code": "453652451",
            "telephone_number": "937-492-1961",
            "fax_number": "937-492-1962"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNOOP",
        "first_name": "WHITNEY",
        "middle_name": "MARYRUTH",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-15",
        "last_updated": "2021-05-10",
        "certification_date": "2021-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.18684",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "WHITNEY",
            "last_name": "DUNCANSON-PEDEVILLA",
            "middle_name": "MARYRUTH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jessica King
• Melissa Ann Kinstle, CNP
• Theresa Ann Kirsch, M.A. CCC-SLP
• Sarah Elizabeth Klein, M.A., CCC-SLP
• Jeffrey Kent Knoderer, DC
• H. Bruce Koch, MD
• Colleen Kortokrax
• Brian Hugh Kramer, P.T
• Kambrilyn Kratzer
• Amy Renae Krites, MSW, LISW

• Family Nurse Practitioner in Sidney, OH
• Providers in Sidney, OH by specialty
• Family Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.