Active NPI
Pamela R Knysz, MD
- Family Medicine Physician
- Boyne City, MI
National Provider Identifier
1619088044
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 4301051283
- Practice address
- 223 N Park St
Boyne City, MI 49712-1220 - Phone
- (231) 582-5314
- Fax
- (231) 582-5338
- NPI assigned
- Aug 31, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 4301051283 | MI | Primary |
Addresses
Primary practice location
223 N Park St
Boyne City, MI 49712-1220
Mailing address
223 N Park St
Boyne City, MI 49712-1220
Phone (231) 582-5314
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4301051283 | MI | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1619088044",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "223 N PARK ST",
"city": "BOYNE CITY",
"state": "MI",
"postal_code": "497121220",
"telephone_number": "231-582-5314",
"fax_number": "231-582-5338"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "223 N PARK ST",
"city": "BOYNE CITY",
"state": "MI",
"postal_code": "497121220",
"telephone_number": "231-582-5314",
"fax_number": "231-582-5338"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KNYSZ",
"first_name": "PAMELA",
"middle_name": "R",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-31",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MI",
"license": "4301051283",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boyne City, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.