Knox Family Medicine

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

35085052 Issued in OH

Legal business name

KNOX FAMILY MEDICINE

Practice address

11 Woodlake TRL
Suite a
Mount Vernon, OH 43050-8113

Phone

(740) 397-3647

Fax

(740) 397-0908

NPI assigned

Jul 27, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. David Matthew Dyck, M.D.NPI 1053303479

Title

Ceo

Phone

(740) 397-3647

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• David M Dyck, MD

  • Family Medicine Physician
  • Elkhart, IN
  • NPI 1053303479
  NPD (past) Authorized official

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1619991379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 WOODLAKE TRL",
            "address_2": "SUITE A",
            "city": "MOUNT VERNON",
            "state": "OH",
            "postal_code": "430508113",
            "telephone_number": "740-397-3647",
            "fax_number": "740-397-0908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 WOODLAKE TRL",
            "address_2": "SUITE A",
            "city": "MOUNT VERNON",
            "state": "OH",
            "postal_code": "430508113",
            "telephone_number": "740-397-3647",
            "fax_number": "740-397-0908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KNOX FAMILY MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DYCK",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "MATTHEW",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "740-397-3647",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35085052",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2558709",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Knox County General Health District (Knox County Community Health Center)
• Knox County General Health District (Behavioral Health of Mount Vernon Health Center)
• Knox County Vision Center LLC
• Knox Diagnostic Imaging LLC
• Knox Emergency Services, LLC
• Knox Gynecological Specialists
• Knox Medical Specialists, Inc
• Knox New Hope Industries, Inc.
• Knox Orthopaedic & Sports Medicine Center, LLC
• Knox Radiology Associates LLC

• Family Medicine Physician in Mount Vernon, OH
• Providers in Mount Vernon, OH by specialty
• Family Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.