Individual provider Active NPI

Larry L Kniess, CRNP

  • Nurse Practitioner
  • Butler, PA
National Provider Identifier
1629608807
Registry record updated Jun 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
SP021242 Issued in PA
Practice address
389 New Castle Rd
Butler, PA 16001-1743
Phone
(724) 282-2216
Fax
(724) 282-1861
NPI assigned
Jan 16, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X SP021242 PA Primary

Addresses

Primary practice location

389 New Castle Rd
Butler, PA 16001-1743

Mailing address

9573 Hager Rd
Meadville, PA 16335-6477

Other practice location 1

5039 Peach St
Erie, PA 16509-2032
Phone (814) 866-1443

Other identifiers 1

IdentifierTypeStateIssuer
SP021242OtherPALICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200219000376 PA Practitioner - Nurse Practitioner 2163859885 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ucmg LLCGroup PAC ID 6709398969, 254 clinicians

Practice addresses (Care Compare)

18471 Smock Hwy
Suite 107
Meadville, PA 16335-3610
Phone (814) 333-3627

4655 William Flynn Hwy
Suite 110 Upmc Gohealth Urgent Care
Allison Park, PA 15101-2248
Phone (412) 486-3027

5039 Peach St
Erie, PA 16509-2032
Phone (814) 866-1443

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
SP021242PAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Medexpress Urgent Care, PC - Pennsylvania CurrentSince Dec 17, 2021 Accepting new patients
Ahn Emergency Group of Erie County LTD. CurrentSince May 4, 2025 Accepting new patients
Urgent Care, PC - Pennsylvania Current Accepting new patients
Ucmg LLC CurrentSince Jan 21, 2026 Accepting new patients
Medexpress Urgent Care, PC - Pennsylvania CurrentSince Dec 17, 2021 Accepting new patients

Locations

4808 Edgmont Ave
Brookhaven, PA 19015
Phone (610) 876-3072

5039 Peach St
Erie, PA 16509
Phone (814) 866-0833

7219 McKnight Rd
Ste F
Pittsburgh, PA 15237
Phone (412) 367-3278

2 W Crescent Park
Warren, PA 16365
Phone (814) 452-5337

Interoperability endpoints

  • Direct secure messaging: lkniess20695@gohealthupmc.direct-ci.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1579132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717977600000",
    "number": "1629608807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9573 HAGER RD",
            "city": "MEADVILLE",
            "state": "PA",
            "postal_code": "163356477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "389 NEW CASTLE RD",
            "city": "BUTLER",
            "state": "PA",
            "postal_code": "160011743",
            "telephone_number": "724-282-2216",
            "fax_number": "724-282-1861"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5039 Peach St",
            "address_purpose": "LOCATION",
            "city": "Erie",
            "state": "PA",
            "postal_code": "165092032",
            "country_code": "US",
            "telephone_number": "814-866-1443",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KNIESS",
        "first_name": "LARRY",
        "middle_name": "L",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-01-16",
        "last_updated": "2024-06-10",
        "certification_date": "2021-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "SP021242",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "SP021242",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Butler, PA

Sources for this page

Verify at the official NPI Registry.