Individual provider Active NPI

Kimberly Michelle Knapp, PT

  • Physical Therapist
  • Tulsa, OK
National Provider Identifier
1689614216
Registry record updated Aug 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2852 Issued in OK
Practice address
6846 S Canton Ave Ste 120
Tulsa, OK 74136-3413
Phone
(918) 806-0106
Fax
(918) 806-0113
NPI assigned
Jun 8, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 16, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2852 OK Primary
Pediatric Physical Therapist 2251P0200X 2852 OK

Addresses

Primary practice location

6846 S Canton Ave Ste 120
Tulsa, OK 74136-3413

Mailing address

6846 S Canton Ave Ste 120
Tulsa, OK 74136-3413
Phone (918) 806-0106

Other practice location 1

127 E 10th Ave
Bristow, OK 74010-2101
Phone (918) 806-0106

Other identifiers 1

IdentifierTypeStateIssuer
100834710MedicaidOK

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)
Not enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
2852OKMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Home Therapy Resources, Inc. Physical Therapist CurrentSince Oct 23, 2022 Accepting new patients
Eden Park Pediatric Associates, LLP Past Accepting new patients

Locations

6846 S Canton Ave
Ste 120
Tulsa, OK 74136
Phone (918) 232-3064

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": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660608000000",
    "number": "1689614216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6846 S CANTON AVE STE 120",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741363413",
            "telephone_number": "918-806-0106",
            "fax_number": "918-806-0113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6846 S CANTON AVE STE 120",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741363413",
            "telephone_number": "918-806-0106",
            "fax_number": "918-806-0113"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "127 E 10th Ave",
            "address_purpose": "LOCATION",
            "city": "Bristow",
            "state": "OK",
            "postal_code": "740102101",
            "country_code": "US",
            "telephone_number": "918-806-0106",
            "fax_number": "918-806-0113",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KNAPP",
        "first_name": "KIMBERLY",
        "middle_name": "MICHELLE",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-08",
        "last_updated": "2022-08-16",
        "certification_date": "2022-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OK",
            "license": "2852",
            "primary": true
        },
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "OK",
            "license": "2852",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100834710",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2022; 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.