Randall Brian Knutson, MD
Individual provider Active NPI Emergency Medicine Physician · Orange Beach, AL
NPI 1689614679 · NPPES record last updated Jul 16, 2009
Key facts
- NPI
- 1689614679
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Emergency Medicine Physician 207P00000X
- License
- 28126 (AL)
- Practice address
- 32199 Sandpiper Dr
Orange Beach, AL 36561-5735 - Phone
- (251) 504-1174
- NPI assigned
- Jun 7, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 5
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20070822001589 | AL | Practitioner - Emergency Medicine | 4486643608 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 28126 | AL | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Baldwin Emergency Physicians, P.C.. | Emergency Medicine | Current |
Accepting new patients |
| Emergency Medicine Physicians of Carteret County, PLLC | Emergency Medicine | Past | Accepting new patients |
| Carolinaeast Medical Center | Past | Accepting new patients | |
| Emergency Medicine Physicians of Craven County, PLLC | Emergency Medicine | Past | Accepting new patients |
| Lima Memorial Joint Operating Company | Past | Accepting new patients |
Locations
29487 State Highway 181
Daphne, AL 36526
Phone (251) 279-5400
750 Morphy Ave
Fairhope, AL 36532
Phone (251) 928-2375
1613 N McKenzie St
Foley, AL 36535
Phone (251) 949-3400
5 Mobile Infirmary Cir
Mobile, AL 36607
Phone (251) 432-4415
95 Shell St
#B
Saraland, AL 36571
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 28126 | AL | Yes |
Addresses
Primary practice location
32199 Sandpiper Dr
Orange Beach, AL 36561-5735
Mailing address
1613 N McKenzie St
Foley, AL 36535-2247
Phone (251) 949-3540
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 009910240 | Medicaid | AL |
Other providers in Orange Beach, AL
- Karin Pardue MD LLC
- Sara Beth Kennedy
- Anthony T Kennon
- James Robert Kimball
- Katey Lynn Kimbro
- Melissa R Lacour
- Jeanette Hinchey Lark
- Lifestyle Performance Medicine
- Jeffrey Allen Lipke
- Look Baldwin LLC
All providers in Orange Beach, AL · Emergency Medicine Physician in Alabama
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 16, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.