Jerry McKnight, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

10970 Issued in AL

Practice address

850 Peter Bryce Blvd
Tuscaloosa, AL 35401-7419

Phone

(205) 348-1770

Fax

(205) 348-6561

NPI assigned

Jan 25, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AL, MS2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Family Practice

Education

University of Tennessee, HSC, College of Medicine, 1982

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southside Pain Specialists, PCGroup PAC ID 0648355016, 6 clinicians

Boa Vida Hospital of Aberdeen Ms LLCGroup PAC ID 0244505840, shared by 26 NPIs, 70 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/2264/brand/1/csg/1/fhir/r4
• FHIR API: https://fhir4.healow.com/fhir/r4/CHBIDD
• Direct secure messaging: jerry.mcknight.1@2264.direct.athenahealth.com

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.

• Southside Pain Specialists, PC

  • Pain Medicine (Anesthesiology) Physician
  • Birmingham, AL
  • NPI 1558546994
  Medicare reassignment Care Compare group NPD
• Summit Physician Group LLP

  • Family Medicine Physician
  • Tuscaloosa, AL
  • NPI 1104343581
  Medicare reassignment NPD
• Pain and Rehabilitation Center Inc

  • Mental Health Counselor
  • Hoover, AL
  • NPI 1518065994
  NPD
• Boa Vida Hospital of Aberdeen, Ms LLC

  • Community/Retail Pharmacy
  • Aberdeen, MS
  • NPI 1134858269
  NPD
• Boa Vida Hospital of Aberdeen, Ms, LLC

  • Multi-Specialty Clinic/Center
  • Aberdeen, MS
  • NPI 1710405741
  NPD

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

{
    "created_epoch": "1138147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1356311005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9174 PARKWAY E",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352061507",
            "telephone_number": "205-498-2675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 PETER BRYCE BLVD",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354017419",
            "telephone_number": "205-348-1770",
            "fax_number": "205-348-6561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKNIGHT",
        "first_name": "JERRY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-25",
        "last_updated": "2023-03-07",
        "certification_date": "2021-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "AL",
            "license": "10970",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AL",
            "license": "10970",
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "AL",
            "license": "10970",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AL",
            "license": "10970",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000011765",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rick L McKenzie, MD
• William K McKibbin, M.D.
• Jeremy R. McKinney, D.M.D., M.D.S.
• Robert Earl McKinney, L.C.S.W.
• John Marvin McKissick, KINESIOTHERAPIST
• Ray Harvey McLaughlin Jr., M.D.
• Kenneth McMullen, LMSW
• Tomeka McNair, CNA
• Joshua McNairy, RKT
• Megan McNally

• Family Medicine Physician in Tuscaloosa, AL
• Providers in Tuscaloosa, AL by specialty
• Family Medicine Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.
• 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.