Individual provider Active NPI

Keith Anthony Knigge, D.O.

  • Emergency Medicine Physician
  • Fort Walton Beach, FL
National Provider Identifier
1386891620
Registry record updated Nov 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
OS15734 Issued in FL
Practice address
1000 Mar Walt Dr
Fort Walton Beach, FL 32547-6708
Phone
(850) 862-1111
NPI assigned
Aug 19, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 18, 2019

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X OP60652158 WA
Emergency Medicine Physician 207P00000X DO.1099 AL
Emergency Medicine Physician 207P00000X O-0997 ID
Emergency Medicine Physician 207P00000X 34.011427 OH
Emergency Medicine Physician 207P00000X OS15734 FL Primary

Addresses

Primary practice location

1000 Mar Walt Dr
Fort Walton Beach, FL 32547-6708

Mailing address

1000 Mar Walt Dr
Fort Walton Beach, FL 32547-6708

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, FL2 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

Enrollment IDStateProvider typePAC IDDetails
I20160912000989 WA Practitioner - Emergency Medicine 9436338837 Reassigns benefits to 2 organizations
I20190117001307 FL Practitioner - Emergency Medicine 9436338837 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
DO.1099ALMDEmergency Medicine Physician
OS15734FLMDEmergency Medicine Physician
OP60652158WAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Medicine Services of FL, LLC Emergency Medicine CurrentSince Apr 1, 2023 Accepting new patients
Northwest Emergency Physicians LLC Emergency Medicine CurrentSince Sep 1, 2018 Accepting new patients
Sound Physicians Emergency Medicine of Washington PLLC Emergency Medicine CurrentSince Oct 1, 2019 Accepting new patients
Public Hospital District #1-a of Whitman County Past Accepting new patients
Blue Job Emergency Physicians LLC Emergency Medicine Past Accepting new patients

Locations

322 SW Pine Island Rd
Cape Coral, FL 33991
Phone (941) 249-6858

200 Tequesta Dr
Destin, FL 32541
Phone (850) 837-9194

1000 Mar Walt Dr
Ft Walton Bch, FL 32547
Phone (850) 374-9610

14000 Fivay Rd
Hudson, FL 34667
Phone (727) 819-2929

20900 Biscayne Blvd
Miami, FL 33180
Phone (305) 682-7290

105 Tamiami Trl
Fl Tamiami
Port Charlotte, FL 33953

915 Anderson Dr
Aberdeen, WA 98520
Phone (360) 532-8330

1211 24th St
Anacortes, WA 98221
Phone (360) 293-3181

801 E Wheeler Rd
Moses Lake, WA 98837
Phone (509) 765-5606

2000 Hospital Dr
Sedro Woolley, WA 98284
Phone (360) 856-6021

1717 S J St
Tacoma, WA 98405
Phone (253) 426-4101

Interoperability endpoints

  • Direct secure messaging: kknigge650955@direct.multicare.org

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1219104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574035200000",
    "number": "1386891620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 MAR WALT DR",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325476708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 MAR WALT DR",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325476708",
            "telephone_number": "850-862-1111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNIGGE",
        "first_name": "KEITH",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-08-19",
        "last_updated": "2019-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WA",
            "license": "OP60652158",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AL",
            "license": "DO.1099",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "ID",
            "license": "O-0997",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "34.011427",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "OS15734",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Walton Beach, FL

Sources for this page

Verify at the official NPI Registry.