Individual provider Active NPI

Suzanne S Knoeppel, D.O.

  • Family Medicine Physician
  • Tampa, FL
National Provider Identifier
1679547152
Registry record updated Dec 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS5507 Issued in FL
Practice address
13515 Lake Terrace LN
Tampa, FL 33637-1003
Phone
(813) 998-8000
NPI assigned
Feb 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OS5507 FL Primary

Addresses

Primary practice location

13515 Lake Terrace LN
Tampa, FL 33637-1003

Mailing address

13515 Lake Terrace LN
Tampa, FL 33637-1003
Phone (813) 998-8000

Other identifiers 2

IdentifierTypeStateIssuer
057669700MedicaidFL
80058OtherFLBLUE CROSS BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200324000967 FL Order and Referring Only - Family PracticePractitioner - Family Practice 2062684053

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

NPI Registry JSON

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

{
    "created_epoch": "1139875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481846400000",
    "number": "1679547152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13515 LAKE TERRACE LN",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336371003",
            "telephone_number": "813-998-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13515 LAKE TERRACE LN",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336371003",
            "telephone_number": "813-998-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNOEPPEL",
        "first_name": "SUZANNE",
        "middle_name": "S",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-14",
        "last_updated": "2016-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS5507",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "057669700",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "80058",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.