Active NPI
Mark A Knoll, DC
- Chiropractor
- Omaha, NE
National Provider Identifier
1639128945
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 841
- Practice address
- 11322 Q St
Omaha, NE 68137-3679 - Phone
- (402) 339-9510
- Fax
- (402) 592-0316
- NPI assigned
- May 6, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 841 | NE | Primary |
Addresses
Primary practice location
11322 Q St
Omaha, NE 68137-3679
Mailing address
11322 Q St
Omaha, NE 68137-3679
Phone (402) 339-9510
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 47068804800 | Medicaid | NE |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 841 | NE | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146873600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1192147200000",
"number": "1639128945",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11322 Q ST",
"city": "OMAHA",
"state": "NE",
"postal_code": "681373679",
"telephone_number": "402-339-9510",
"fax_number": "402-592-0316"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11322 Q ST",
"city": "OMAHA",
"state": "NE",
"postal_code": "681373679",
"telephone_number": "402-339-9510",
"fax_number": "402-592-0316"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KNOLL",
"first_name": "MARK",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-05-06",
"last_updated": "2007-10-12",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "NE",
"license": "841",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "47068804800",
"state": "NE"
}
],
"endpoints": [],
"other_names": []
}Other providers in Omaha, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.