Individual provider Active NPI

Thomas A McKnight, MD

  • Family Medicine Physician
  • Fremont, NE
National Provider Identifier
1679587778
Registry record updated Jul 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
15494 Issued in NE
Practice address
350 W 23Rd St
Ste a
Fremont, NE 68025-2592
Phone
(402) 721-7077
Fax
(402) 753-6056
NPI assigned
Jul 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2013

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 15494 NE Primary

Addresses

Primary practice location

350 W 23Rd St
Ste a
Fremont, NE 68025-2592

Mailing address

PO Box 11724
Belfast, ME 04915-4008
Phone (402) 721-7077

Other identifiers 3

IdentifierTypeStateIssuer
P00243529OtherRR MR
10025238700MedicaidNE
07247OtherNENE BCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
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
I20050420001210 NE Practitioner - Family Practice 6002854189 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
15494NEMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Physicians Clinic Inc Family Medicine CurrentSince Mar 17, 2020 Accepting new patients
Geoffrey C. Basler, M.D. P.C. Past Accepting new patients

Locations

2540 N Healthy Way
Fremont, NE 68025
Phone (402) 721-3133

350 W 23rd St
Ste A
Fremont, NE 68025
Phone (402) 721-7077

350 W 23rd St
Fremont, NE 68025
Phone (402) 721-2444

10060 Regency Cir
Omaha, NE 68114
Phone (402) 354-1405

825 S 169th St
Fl 3
Omaha, NE 68118
Phone (402) 354-5451

Organizations & group practices 2

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": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374019200000",
    "number": "1679587778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11724",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "049154008",
            "telephone_number": "402-721-7077",
            "fax_number": "402-753-6056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 W 23RD ST",
            "address_2": "STE A",
            "city": "FREMONT",
            "state": "NE",
            "postal_code": "680252592",
            "telephone_number": "402-721-7077",
            "fax_number": "402-753-6056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKNIGHT",
        "first_name": "THOMAS",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2013-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NE",
            "license": "15494",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MR",
            "identifier": "P00243529",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025238700",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NE BCBS",
            "identifier": "07247",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fremont, NE

Sources for this page

Verify at the official NPI Registry.