Individual provider Active NPI

Gerald L Knouf, MD

  • Family Medicine Physician
  • Lewiston, ID
National Provider Identifier
1609989359
Registry record updated Feb 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
M5074 Issued in ID
Practice address
415 6TH St
Lewiston, ID 83501
Phone
(208) 750-7300
Fax
(208) 746-4899
NPI assigned
Aug 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME156986 FL
Family Medicine Physician 207Q00000X M5074 ID Primary

Addresses

Primary practice location

415 6TH St
Lewiston, ID 83501

Mailing address

415 6TH St
Lewiston, ID 83501-2431
Phone (208) 750-7300

Other practice location 1

11531 N 56th St Ste 103
Temple Terrace, FL 33617-2238
Phone (813) 999-4963

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
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
I20061201000433 ID Practitioner - Family Practice 2365426608 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5074IDMDProfessional Counselor
M5074IDMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Joseph Hospital LLC CurrentSince Jan 1, 2024 Accepting new patients
Metcare of Florida PastSince Nov 1, 2022 Accepting new patients

Locations

821 21st Ave
Lewiston, ID 83501
Phone (208) 799-3422

222 Southway Ave
Ste 2B
Lewiston, ID 83501
Phone (208) 799-5370

415 6th St
Lewiston, ID 83501
Phone (208) 750-7445

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1155686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708560000000",
    "number": "1609989359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 6TH ST",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835012431",
            "telephone_number": "208-750-7300",
            "fax_number": "208-746-4899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 6TH ST",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "83501",
            "telephone_number": "208-750-7300",
            "fax_number": "208-746-4899"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11531 N 56th St Ste 103",
            "address_purpose": "LOCATION",
            "city": "Temple Terrace",
            "state": "FL",
            "postal_code": "336172238",
            "country_code": "US",
            "telephone_number": "813-999-4963",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KNOUF",
        "first_name": "GERALD",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-16",
        "last_updated": "2024-02-22",
        "certification_date": "2024-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME156986",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ID",
            "license": "M5074",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lewiston, ID

Sources for this page

Verify at the official NPI Registry.