Individual provider Active NPI

Jeffery David Knytych, NMD

  • Naturopath
  • Phoenix, AZ
National Provider Identifier
1629101795
Registry record updated Jan 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
NaturopathTaxonomy code 175F00000X
License
02-684 Issued in AZ
Practice address
20823 N Cave Creek Rd
103
Phoenix, AZ 85024-4468
Phone
(602) 326-9377
NPI assigned
Mar 14, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 26, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Naturopath 175F00000X 02-684 AZ Primary

Addresses

Primary practice location

20823 N Cave Creek Rd
103
Phoenix, AZ 85024-4468

Mailing address

PO Box 10836
Glendale, AZ 85318-0836
Phone (602) 326-9377

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
02-684AZMDNaturopath

NPI Registry JSON

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

{
    "created_epoch": "1173830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327536000000",
    "number": "1629101795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10836",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853180836",
            "telephone_number": "602-326-9377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20823 N CAVE CREEK RD",
            "address_2": "103",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850244468",
            "telephone_number": "602-326-9377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNYTYCH",
        "first_name": "JEFFERY",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "NMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-14",
        "last_updated": "2012-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175F00000X",
            "taxonomy_group": "",
            "desc": "Naturopath",
            "state": "AZ",
            "license": "02-684",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2012; 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.