Individual provider Active NPI

Brittney Knudson, PA

  • Physician Assistant
  • Spokane, WA
National Provider Identifier
1447657812
Registry record updated Dec 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA61166618 Issued in WA
Practice address
820 S McClellan St Ste 118
Spokane, WA 99204-2446
Phone
(509) 838-7100
Fax
(509) 227-7070
NPI assigned
Dec 1, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 4540 CO
Physician Assistant 363A00000X PA61166618 WA Primary

Addresses

Primary practice location

820 S McClellan St Ste 118
Spokane, WA 99204-2446

Mailing address

PO Box 421
Liberty Lake, WA 99019-0421
Phone (866) 747-2455

Other practice location 1

2055 N High St Ste 370
Denver, CO 80205-5545
Phone (303) 839-6001

Other identifiers 1

IdentifierTypeStateIssuer
88830063MedicaidCO

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210901002882 WA Practitioner - Physician Assistant 4789925983 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Plastic Surgery Northwest PLLCGroup PAC ID 8022105329, 9 clinicians

Practice addresses (Care Compare)

530 S Cowley St
Spokane, WA 99202-1316
Phone (509) 838-1010

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
4540COMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services Washington CurrentSince Nov 1, 2021 Accepting new patients

Locations

1200 E Columbia Ave
Colville, WA 99114
Phone (509) 684-3701

820 S McClellan St
Ste 118
Spokane, WA 99204
Phone (509) 747-3147

820 S McClellan St
Spokane, WA 99204
Phone (509) 747-1144

530 S Cowley St
Ste 100
Spokane, WA 99202
Phone (509) 838-7028

530 S Cowley St
Spokane, WA 99202
Phone (509) 838-1010

Interoperability endpoints

  • Direct secure messaging: bknudson1990315@wm.providencedirect.org
  • Direct secure messaging: brittney.knudson@hca3.eclinicaldirectplus.com

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": "1417392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638662400000",
    "number": "1447657812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 421",
            "city": "LIBERTY LAKE",
            "state": "WA",
            "postal_code": "990190421",
            "telephone_number": "866-747-2455",
            "fax_number": "509-227-7070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 S MCCLELLAN ST STE 118",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992042446",
            "telephone_number": "509-838-7100",
            "fax_number": "509-227-7070"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2055 N High St Ste 370",
            "address_purpose": "LOCATION",
            "city": "Denver",
            "state": "CO",
            "postal_code": "802055545",
            "country_code": "US",
            "telephone_number": "303-839-6001",
            "fax_number": "303-839-6033",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KNUDSON",
        "first_name": "BRITTNEY",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-12-01",
        "last_updated": "2021-12-05",
        "certification_date": "2021-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "4540",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA61166618",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "88830063",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

Verify at the official NPI Registry.