Organization Active NPI

Brian Knight DO LLC

  • Neuromusculoskeletal Medicine & OMM Physician
  • Gresham, OR
National Provider Identifier
1386630010
Registry record updated Jul 14, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neuromusculoskeletal Medicine & OMM PhysicianTaxonomy code 204D00000X
License
DO21549 Issued in OR
Legal business name
BRIAN KNIGHT DO LLC
Practice address
1217 NE Burnside Rd
Suite 103
Gresham, OR 97030
Phone
(503) 489-1999
Fax
(503) 489-2011
NPI assigned
Sep 27, 2005
Last updated
Jul 14, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2009

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

Authorized official

Name
Brian George Knight, DONPI 1831186774
Title
Physician/Resident
Phone
(503) 489-1999

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neuromusculoskeletal Medicine & OMM Physician 204D00000X DO21549 OR Primary

Addresses

Primary practice location

1217 NE Burnside Rd
Suite 103
Gresham, OR 97030

Mailing address

1217 NE Burnside Rd
Suite 103
Gresham, OR 97030
Phone (503) 489-1999

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051010000634 OR Part B Supplier - Clinic/Group Practice 8527083476 Receives reassigned benefits from 1 practitioner
Practice locations: Gresham, OR

National Provider Directory

National Provider Directory

Locations

1217 NE Burnside Rd
Ste 103
Gresham, OR 97030
Phone (503) 257-5905

10373 NE Hancock St
Ste 222
Portland, OR 97220
Phone (503) 251-4229

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1127779200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1247529600000",
    "number": "1386630010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1217 NE BURNSIDE RD",
            "address_2": "SUITE 103",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "97030",
            "telephone_number": "503-489-1999",
            "fax_number": "503-489-2011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1217 NE BURNSIDE RD",
            "address_2": "SUITE 103",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "97030",
            "telephone_number": "503-489-1999",
            "fax_number": "503-489-2011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIAN KNIGHT DO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-27",
        "last_updated": "2009-07-14",
        "status": "A",
        "authorized_official_last_name": "KNIGHT",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "GEORGE",
        "authorized_official_title_or_position": "PHYSICIAN/RESIDENT",
        "authorized_official_telephone_number": "503-489-1999",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "204D00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine & OMM",
            "state": "OR",
            "license": "DO21549",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gresham, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.