Individual provider Active NPI

Benjamin David Knick, DO

  • Student in an Organized Health Care Education/Training Program
  • Roanoke, VA
National Provider Identifier
1508669045
Registry record updated Jun 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
1906 Belleview Ave SE
Roanoke, VA 24014-1838
Phone
(540) 981-7000
NPI assigned
Mar 31, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

1906 Belleview Ave SE
Roanoke, VA 24014-1838

Mailing address

2145 Mount Pleasant Blvd SE
Roanoke, VA 24014-3632
Phone (540) 427-9200

Other practice location 1

1970 Roanoke Blvd
Salem, VA 24153-6404
Phone (540) 982-2463

Other practice location 2

1314 Peters Creek Rd NW
Roanoke, VA 24017-2500
Phone (540) 562-5703

Other practice location 3

2145 Mount Pleasant Blvd SE
Roanoke, VA 24014-3632
Phone (540) 427-9200

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20260626003052 VA Order and Referring Only - Family PracticePractitioner - Family Practice 1355814674

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

NPI Registry JSON

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

{
    "created_epoch": "1743379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780531200000",
    "number": "1508669045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2145 MOUNT PLEASANT BLVD SE",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240143632",
            "telephone_number": "540-427-9200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1906 BELLEVIEW AVE SE",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240141838",
            "telephone_number": "540-981-7000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1970 Roanoke Blvd",
            "address_purpose": "LOCATION",
            "city": "Salem",
            "state": "VA",
            "postal_code": "241536404",
            "country_code": "US",
            "telephone_number": "540-982-2463",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1314 Peters Creek Rd NW",
            "address_purpose": "LOCATION",
            "city": "Roanoke",
            "state": "VA",
            "postal_code": "240172500",
            "country_code": "US",
            "telephone_number": "540-562-5703",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2145 Mount Pleasant Blvd SE",
            "address_purpose": "LOCATION",
            "city": "Roanoke",
            "state": "VA",
            "postal_code": "240143632",
            "country_code": "US",
            "telephone_number": "540-427-9200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KNICK",
        "first_name": "BENJAMIN",
        "middle_name": "DAVID",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-03-31",
        "last_updated": "2026-06-04",
        "certification_date": "2026-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roanoke, VA

Sources for this page

Verify at the official NPI Registry.