Individual provider Active NPI

Tonya E. Knowles, BA

  • Case Manager/Care Coordinator
  • Fort Myers, FL
National Provider Identifier
1336483668
Registry record updated Nov 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
License
K542805838610 Issued in FL
Practice address
2789 Ortiz Ave
Fort Myers, FL 33905-7806
Phone
(239) 791-1586
NPI assigned
Nov 27, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 27, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X K542805838610 FL Primary

Addresses

Primary practice location

2789 Ortiz Ave
Fort Myers, FL 33905-7806

Mailing address

2789 Ortiz Ave
Fort Myers, FL 33905-7806
Phone (239) 791-1586

Other identifiers 1

IdentifierTypeStateIssuer
K542805838610OtherFLDRIVERS LICENSE

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
Credentials
Bachelor of Arts

State licenses

LicenseStateTypeSpecialty
K542805838610FLMDCase Manager/Care Coordinator

NPI Registry JSON

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

{
    "created_epoch": "1353974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353974400000",
    "number": "1336483668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2789 ORTIZ AVE",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339057806",
            "telephone_number": "239-791-1586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2789 ORTIZ AVE",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339057806",
            "telephone_number": "239-791-1586"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNOWLES",
        "first_name": "TONYA",
        "middle_name": "E.",
        "credential": "BA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-11-27",
        "last_updated": "2012-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "FL",
            "license": "K542805838610",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DRIVERS LICENSE",
            "identifier": "K542805838610",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.