Individual provider Active NPI

Samuel Dunn Holzknecht, DPT

  • Physical Therapist
  • Seymour, IN
National Provider Identifier
1619217767
Registry record updated Feb 27, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
05011059A Issued in IN
Practice address
1171 W Tipton St
Suite L
Seymour, IN 47274-2793
Phone
(812) 522-7007
NPI assigned
Feb 27, 2013
Last updated
Feb 27, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 05011059A IN Primary

Addresses

Primary practice location

1171 W Tipton St
Suite L
Seymour, IN 47274-2793

Mailing address

1171 W Tipton St
Suite L
Seymour, IN 47274-2793
Phone (812) 522-7007

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

State licenses

LicenseStateTypeSpecialty
05011059AINMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1361923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361923200000",
    "number": "1619217767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1171 W TIPTON ST",
            "address_2": "SUITE L",
            "city": "SEYMOUR",
            "state": "IN",
            "postal_code": "472742793",
            "telephone_number": "812-522-7007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1171 W TIPTON ST",
            "address_2": "SUITE L",
            "city": "SEYMOUR",
            "state": "IN",
            "postal_code": "472742793",
            "telephone_number": "812-522-7007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLZKNECHT",
        "first_name": "SAMUEL",
        "middle_name": "DUNN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-02-27",
        "last_updated": "2013-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "05011059A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seymour, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2013; 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.