Knicley SE, LLC

Primary specialty

Orthopedic Physical TherapistTaxonomy code 2251X0800X

License

23476 Issued in MD

Legal business name

KNICLEY SE, LLC

Doing business as

Structural Elements

Practice address

3540 Sugarloaf Pkwy Ste D03
Frederick, MD 21704-7901

Phone

(301) 992-6797

NPI assigned

Nov 6, 2017

Organization subpart

No

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

Authorized official

Name

Jason Knicley, PT, DPTNPI 1376844613

Title

PT, Owner, Operator

Phone

(301) 992-6797

Specialties & licenses 1

Addresses

Other names 1

• Structural Elements Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jason William Knicley, DPT

  • Physical Therapist
  • Frederick, MD
  • NPI 1376844613
  NPD Authorized official

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

{
    "created_epoch": "1509926400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626048000000",
    "number": "1619480258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10938 LOUIS DETRICK LN",
            "city": "MONROVIA",
            "state": "MD",
            "postal_code": "217706030",
            "telephone_number": "301-992-6797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3540 SUGARLOAF PKWY STE D03",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217047901",
            "telephone_number": "301-992-6797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KNICLEY SE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-06",
        "last_updated": "2021-07-12",
        "certification_date": "2021-07-12",
        "status": "A",
        "authorized_official_last_name": "KNICLEY",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "PT, OWNER, OPERATOR",
        "authorized_official_telephone_number": "301-992-6797",
        "authorized_official_credential": "PT, DPT"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Orthopedic",
            "state": "MD",
            "license": "23476",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Structural Elements",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Susanna Klingler
• Jane Ellen Klink, PT
• Michael Knable, D.O.
• Charles Ira Knapp, DDS, MA, MS
• Lara Rubey Dean Knepper, LCSW-C
• Jason William Knicley, DPT
• Roy Knight
• Alison Knotek, CD(DONA)
• Dana Lea Knott, LCSW-C
• Theresa Knox

• Orthopedic Physical Therapist in Frederick, MD
• Providers in Frederick, MD by specialty
• Orthopedic Physical Therapist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2021; 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.