Active NPI
Timothy Karnuth, PA-C
- Physician Assistant
- Jbsa Ft Sam Houston, TX
National Provider Identifier
1457834814
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- Practice address
- 3551 Roger Brooke Dr
Jbsa Ft Sam Houston, TX 78234-4504 - Phone
- (210) 916-4141
- NPI assigned
- Sep 12, 2018
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | Primary |
Addresses
Primary practice location
3551 Roger Brooke Dr
Jbsa Ft Sam Houston, TX 78234-4504
Mailing address
3551 Roger Brooke Dr
Jbsa Ft Sam Houston, TX 78234-4504
Other practice location 1
6600 Van Aalst Blvd
Fort Benning, GA 31905
Phone (618) 719-6747
Other practice location 2
11050 Mount Belvedere Blvd
Fort Drum, NY 13602-5438
Phone (618) 719-6747
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2013021541 | Other | MO | MISSOURI STATE BOARD OF NURSING |
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
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 024595 | NY | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1536710400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1741132800000",
"number": "1457834814",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3551 ROGER BROOKE DR",
"city": "JBSA FT SAM HOUSTON",
"state": "TX",
"postal_code": "782344504"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3551 ROGER BROOKE DR",
"city": "JBSA FT SAM HOUSTON",
"state": "TX",
"postal_code": "782344504",
"telephone_number": "210-916-4141"
}
],
"practiceLocations": [
{
"address_1": "6600 Van Aalst Blvd",
"address_purpose": "LOCATION",
"city": "Fort Benning",
"state": "GA",
"postal_code": "31905",
"country_code": "US",
"telephone_number": "618-719-6747",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "11050 Mount Belvedere Blvd",
"address_purpose": "LOCATION",
"city": "Fort Drum",
"state": "NY",
"postal_code": "136025438",
"country_code": "US",
"telephone_number": "618-719-6747",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KARNUTH",
"first_name": "TIMOTHY",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-09-12",
"last_updated": "2025-03-05",
"certification_date": "2025-03-05",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MISSOURI STATE BOARD OF NURSING",
"identifier": "2013021541",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Jbsa Ft Sam Houston, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.