Roger S Knapp II, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

E1001 Issued in TX

Practice address

480 W Southlake Blvd
Ste 133
Southlake, TX 76092-6162

Phone

(817) 329-9234

Fax

(817) 329-9239

NPI assigned

Oct 26, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 12

Medicare fee-for-service enrollment

Enrolled in TX

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Cook Children'S Physician Network

  • Pediatrics Physician
  • Fort Worth, TX
  • NPI 1750369203
  Medicare reassignment NPD
• Cook Children'S Physician Network

  • Pediatrics Physician
  • Fort Worth, TX
  • NPI 1083472062
  NPD

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460937600000",
    "number": "1457436602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 99371",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761990371",
            "telephone_number": "682-885-1855",
            "fax_number": "682-885-7347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "480 W SOUTHLAKE BLVD",
            "address_2": "STE 133",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760926162",
            "telephone_number": "817-329-9234",
            "fax_number": "817-329-9239"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNAPP",
        "first_name": "ROGER",
        "middle_name": "S",
        "name_suffix": "II",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-26",
        "last_updated": "2016-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "E1001",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSTX IND PIN",
            "identifier": "87350S",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CCHIP PIN",
            "identifier": "KNARC17962",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHCS PIN",
            "identifier": "152424",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PIN",
            "identifier": "4369262",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRSTHEALTH PIN",
            "identifier": "737821",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSTX GRP PIN",
            "identifier": "00U87Z",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GRP NPI NUMBER",
            "identifier": "1750369203",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "117218102",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "140442831",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHC PIN",
            "identifier": "47652",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "140442870",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA PIN",
            "identifier": "2961700",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marla Jan Klein
• Samantha Klein, MA, BCBA, LBA
• Donna June Klement, NP-C
• Heather Jo Kline, FNP-C
• Gregory B Kloesel, O.D.
• John T Knight, M.D.
• Know Your Worth Counseling and Wellness
• Matthew Kobeszko, M.D.
• Madhuri Latha Koganti, M.D.
• Adam Cash Kokenzie, ATC, LAT, MAT

• Pediatrics Physician in Southlake, TX
• Providers in Southlake, TX by specialty
• Pediatrics Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.