Individual provider Active NPI

John Marshall Knox II, MD

  • Dermatology Physician
  • Kihei, HI
National Provider Identifier
1396749347
Registry record updated Jan 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
MD12517 Issued in HI
Practice address
375 Huku Lii PL
Suite 201
Kihei, HI 96753-8996
Phone
(808) 875-7477
Fax
(808) 879-4585
NPI assigned
Jun 8, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2015

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X F9684 TX
Dermatology Physician 207N00000X MD12517 HI Primary
Dermatology Physician 207N00000X MD60199612 WA

Addresses

Primary practice location

375 Huku Lii PL
Suite 201
Kihei, HI 96753-8996

Mailing address

375 Huku Lii PL
Suite 201
Kihei, HI 96753-8996
Phone (808) 875-7477

Other identifiers 4

IdentifierTypeStateIssuer
P00985643OtherWAPALMETTO RR MEDICARE
0087KNOtherWAREGENCE
1396749347MedicaidWA
274442OtherWALNI

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD12517HIMDDermatology Physician
F9684TXMDDermatology Physician
MD60199612WAMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
True Dermatology PLLC Dermatology Past Accepting new patients
Premier Dermatology & Skin Renewal Center Dermatology Past Accepting new patients
Kenny R. Malott M.D. Inc. Dermatology PastSince Feb 15, 2006 Accepting new patients

Organizations & group practices 3

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": "1118188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1422316800000",
    "number": "1396749347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "375 HUKU LII PL",
            "address_2": "SUITE 201",
            "city": "KIHEI",
            "state": "HI",
            "postal_code": "967538996",
            "telephone_number": "808-875-7477",
            "fax_number": "808-879-4585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "375 HUKU LII PL",
            "address_2": "SUITE 201",
            "city": "KIHEI",
            "state": "HI",
            "postal_code": "967538996",
            "telephone_number": "808-875-7477",
            "fax_number": "808-879-4585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNOX",
        "first_name": "JOHN",
        "middle_name": "MARSHALL",
        "name_suffix": "II",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-08",
        "last_updated": "2015-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "TX",
            "license": "F9684",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "HI",
            "license": "MD12517",
            "primary": true
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "WA",
            "license": "MD60199612",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO RR MEDICARE",
            "identifier": "P00985643",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE",
            "identifier": "0087KN",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1396749347",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LNI",
            "identifier": "274442",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kihei, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2015; 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.