Active NPI
John Marshall Knox II, MD
- Dermatology Physician
- Kihei, HI
National Provider Identifier
1396749347
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- MD12517
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P00985643 | Other | WA | PALMETTO RR MEDICARE |
| 0087KN | Other | WA | REGENCE |
| 1396749347 | Medicaid | WA | |
| 274442 | Other | WA | LNI |
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
| License | State | Type | Specialty |
|---|---|---|---|
| MD12517 | HI | MD | Dermatology Physician |
| F9684 | TX | MD | Dermatology Physician |
| MD60199612 | WA | MD | Dermatology Physician |
Practice roles
| Organization | Specialty | Status | New 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 | Past | 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.
-
- Dermatology Physician
- Kihei, HI
- NPI 1265902670
-
- Clinical & Laboratory Dermatological Immunology Physician
- Bentonville, AR
- NPI 1912912361
Dermatology
-
- Dermatology Physician
- Fayetteville, AR
- NPI 1386022283
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.