Mackenzie Knabe, CST

Primary specialty

Surgical TechnologistTaxonomy code 246ZS0410X

License

237.000.147 Issued in IL

Practice address

1604 Visa Dr Ste 2
Normal, IL 61761-2195

Phone

(309) 846-4716

Fax

(309) 454-7348

NPI assigned

Dec 15, 2015

Last updated

Dec 15, 2015By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Your Extra Hands Surgical Services

  • Surgical Assistant
  • Normal, IL
  • NPI 1154502466
  NPD (past)

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

{
    "created_epoch": "1450137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450137600000",
    "number": "1578928784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1604 VISA DR STE 2",
            "city": "NORMAL",
            "state": "IL",
            "postal_code": "617612195",
            "telephone_number": "309-846-4716",
            "fax_number": "309-454-7348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1604 VISA DR STE 2",
            "city": "NORMAL",
            "state": "IL",
            "postal_code": "617612195",
            "telephone_number": "309-846-4716",
            "fax_number": "309-454-7348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNABE",
        "first_name": "MACKENZIE",
        "credential": "CST",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-12-15",
        "last_updated": "2015-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246ZS0410X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Technologist",
            "state": "IL",
            "license": "237.000.147",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sungjin Kim, MSC, RN
• Elkanah Israel Kindseth, PHARMD
• Shelly King, CCC-SLP
• Traci Kissinger, PT
• Peter Klinkner, LCSW
• Brenna Catherine Maxine Knott
• Kari And Edward Knowlton Green
• Jason Kobler, CRNA
• David Koch, M.D.
• Valerie Koch, PHARMD

• Surgical Technologist in Normal, IL
• Providers in Normal, IL by specialty
• Surgical Technologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.