Individual provider Active NPI

Justin Michael Knowles, MSW

  • Social Worker
  • Fairbanks, AK
National Provider Identifier
1508409863
Registry record updated Oct 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Practice address
3101 Lathrop St
Fairbanks, AK 99701-7426
Phone
(907) 459-4700
NPI assigned
Oct 18, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X Primary

Addresses

Primary practice location

3101 Lathrop St
Fairbanks, AK 99701-7426

Mailing address

3101 Lathrop St
Fairbanks, AK 99701-7426
Phone (907) 459-4700

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240401000688 AK Practitioner - Clinical Social Worker 8022456714 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ge Family Services LLCGroup PAC ID 0244697712, 7 clinicians

Practice addresses (Care Compare)

341 W Tudor Rd
Suite 209
Anchorage, AK 99503-6648
Phone (907) 331-0576

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Ge Family Services LLC CurrentSince Mar 19, 2024 Accepting new patients

Locations

341 W Tudor Rd
Ste 209
Anchorage, AK 99503
Phone (855) 508-1075

Organizations & group practices 1

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": "1571356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571356800000",
    "number": "1508409863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3101 LATHROP ST",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997017426",
            "telephone_number": "907-459-4700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3101 LATHROP ST",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997017426",
            "telephone_number": "907-459-4700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNOWLES",
        "first_name": "JUSTIN",
        "middle_name": "MICHAEL",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-10-18",
        "last_updated": "2019-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairbanks, AK

Sources for this page

Verify at the official NPI Registry.