Active NPI
Lisa Ann Knudson, LICSW
- Social Worker
- Chaska, MN
National Provider Identifier
1639246952
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 10527
- Practice address
- 562 Bavaria LN
Chaska, MN 55318-4597 - Phone
- (952) 484-3509
- Fax
- (952) 934-2147
- NPI assigned
- Nov 30, 2006
- Last updated
- Jan 6, 2015
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Social Worker | 104100000X | 10527 | MN | Primary |
Addresses
Primary practice location
562 Bavaria LN
Chaska, MN 55318-4597
Mailing address
8780 Reflections Rd
Chanhassen, MN 55317-4003
Phone (952) 484-3509
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4138228110 | Medicaid | MN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 1991
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
562 Bavaria LN
Chaska, MN 55318-4597
Phone (952) 484-3509
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10527 | MN | MD | Physician Assistant |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Community/Behavioral Health Agency
- Chaska, MN
- NPI 1588818769
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164844800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1420502400000",
"number": "1639246952",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8780 REFLECTIONS RD",
"city": "CHANHASSEN",
"state": "MN",
"postal_code": "553174003",
"telephone_number": "952-484-3509",
"fax_number": "952-934-2147"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "562 BAVARIA LN",
"city": "CHASKA",
"state": "MN",
"postal_code": "553184597",
"telephone_number": "952-484-3509",
"fax_number": "952-934-2147"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KNUDSON",
"first_name": "LISA",
"middle_name": "ANN",
"name_prefix": "Ms.",
"credential": "LICSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-11-30",
"last_updated": "2015-01-06",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "MN",
"license": "10527",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4138228110",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Chaska, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.