Active NPI
Jonathan Ramsey Kniskern, PH.D.
- Clinical Psychologist
- Marquette, MI
National Provider Identifier
1679620413
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 6301005953
- Practice address
- 102 W Washington St
Suite 226
Marquette, MI 49855-4368 - Phone
- (906) 228-4747
- Fax
- (906) 226-2044
- NPI assigned
- Jan 4, 2007
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 6301005953 | MI | Primary |
Addresses
Primary practice location
102 W Washington St
Suite 226
Marquette, MI 49855-4368
Mailing address
PO Box 312
Marquette, MI 49855-0312
Phone (906) 226-6675
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 68OE245110 | Other | BLUE CROSS BLUE SHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167868800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1679620413",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 312",
"city": "MARQUETTE",
"state": "MI",
"postal_code": "498550312",
"telephone_number": "906-226-6675"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "102 W WASHINGTON ST",
"address_2": "SUITE 226",
"city": "MARQUETTE",
"state": "MI",
"postal_code": "498554368",
"telephone_number": "906-228-4747",
"fax_number": "906-226-2044"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KNISKERN",
"first_name": "JONATHAN",
"middle_name": "RAMSEY",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-04",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MI",
"license": "6301005953",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "68OE245110",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Marquette, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.