Individual provider Active NPI

Steven David Knoblock, CRNA

  • Certified Registered Nurse Anesthetist
  • Royal Oak, MI
National Provider Identifier
1497188551
Registry record updated Aug 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
3398916 Issued in MI
Practice address
134 N Vermont Ave
Royal Oak, MI 48067-2018
Phone
(248) 770-8748
NPI assigned
Aug 13, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 3401179 MI
Certified Registered Nurse Anesthetist 367500000X 3398916 MI Primary

Addresses

Primary practice location

134 N Vermont Ave
Royal Oak, MI 48067-2018

Mailing address

134 N Vermont Ave
Royal Oak, MI 48067-2018
Phone (248) 770-8748

Other identifiers 1

IdentifierTypeStateIssuer
3398916OtherMINURSE ANESTHETIST SPECIALTY CERTIFICATION

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131030000416 MI Practitioner - Certified Registered Nurse Anesthetist (Crna) 2264667104 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Henry Ford Health SystemGroup PAC ID 0547178311, 2,550 clinicians

Practice addresses (Care Compare)

2799 W Grand Boulevard
Detroit, MI 48202-2608
Phone (313) 916-2600

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
3401179MIMDRegistered Nurse
3398916MIMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Health System CurrentSince Aug 1, 2013 Accepting new patients
Henry Ford Health System Nurse Anesthetist, Certified Registered CurrentSince Aug 1, 2013 Accepting new patients

Locations

1 Ford Pl
Ste 2E
Detroit, MI 48202
Phone (313) 874-3953

2799 W Grand Blvd
Detroit, MI 48202
Phone (313) 876-2062

Interoperability endpoints

  • Direct secure messaging: sknoblock207906@direct.hfhs.org

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1376352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376352000000",
    "number": "1497188551",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "134 N VERMONT AVE",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480672018",
            "telephone_number": "248-770-8748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "134 N VERMONT AVE",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480672018",
            "telephone_number": "248-770-8748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNOBLOCK",
        "first_name": "STEVEN",
        "middle_name": "DAVID",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-08-13",
        "last_updated": "2013-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "3401179",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "3398916",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NURSE ANESTHETIST SPECIALTY CERTIFICATION",
            "identifier": "3398916",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Royal Oak, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.