Individual provider Active NPI

James Alden McKnight, D.D.S.

  • Dentist
  • Plattsmouth, NE
National Provider Identifier
1396816252
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
4463 Issued in NE
Practice address
2302 8TH Ave
Suite 2
Plattsmouth, NE 68048-2365
Phone
(402) 296-2818
Fax
(402) 296-2510
NPI assigned
Nov 13, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 4463 NE Primary

Addresses

Primary practice location

2302 8TH Ave
Suite 2
Plattsmouth, NE 68048-2365

Mailing address

2302 8TH Ave
Suite 2
Plattsmouth, NE 68048-2365
Phone (402) 296-2818

Other identifiers 1

IdentifierTypeStateIssuer
47057747900MedicaidNE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161109002176 NE Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 1052690393

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4463NEMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1396816252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2302 8TH AVE",
            "address_2": "SUITE 2",
            "city": "PLATTSMOUTH",
            "state": "NE",
            "postal_code": "680482365",
            "telephone_number": "402-296-2818",
            "fax_number": "402-296-2510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2302 8TH AVE",
            "address_2": "SUITE 2",
            "city": "PLATTSMOUTH",
            "state": "NE",
            "postal_code": "680482365",
            "telephone_number": "402-296-2818",
            "fax_number": "402-296-2510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKNIGHT",
        "first_name": "JAMES",
        "middle_name": "ALDEN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NE",
            "license": "4463",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47057747900",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Plattsmouth, NE

Sources for this page

Verify at the official NPI Registry.