Individual provider Active NPI

Thomas L McKnight, MD

  • Family Medicine Physician
  • Niceville, FL
National Provider Identifier
1679554422
Registry record updated Jan 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME91767 Issued in FL
Practice address
4566 E Highway 20
Suite 105
Niceville, FL 32578-8838
Phone
(850) 279-6949
Fax
(850) 279-6033
NPI assigned
Nov 9, 2005
Last updated
Jan 23, 2014By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 23, 2014

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 ME91767 FL Primary

Addresses

Primary practice location

4566 E Highway 20
Suite 105
Niceville, FL 32578-8838

Mailing address

4566 E Highway 20
Suite 105
Niceville, FL 32578-8838
Phone (850) 729-9407

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
21339SCMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Due West Family Medicine PA Past Accepting new patients
Freeport Family Medicine LLC Family Medicine Past Accepting new patients
Okaloosa Hospital Inc Past Accepting new patients
Due West Family Medicine Family Medicine Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1131494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390435200000",
    "number": "1679554422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4566 E HIGHWAY 20",
            "address_2": "SUITE 105",
            "city": "NICEVILLE",
            "state": "FL",
            "postal_code": "325788838",
            "telephone_number": "850-729-9407",
            "fax_number": "850-729-9417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4566 E HIGHWAY 20",
            "address_2": "SUITE 105",
            "city": "NICEVILLE",
            "state": "FL",
            "postal_code": "325788838",
            "telephone_number": "850-279-6949",
            "fax_number": "850-279-6033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKNIGHT",
        "first_name": "THOMAS",
        "middle_name": "L",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-09",
        "last_updated": "2014-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME91767",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Niceville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2014; 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.