Melissa M Knuckles, MPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

070021390 Issued in IL

Practice address

880 Columbia Ctr
Columbia, IL 62236-2567

Phone

(618) 281-9699

Fax

(618) 281-9698

NPI assigned

Nov 21, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Melissa Penberthy Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• FLS Physical Therapy Associates PC

  • Physical Therapy Clinic/Center
  • Columbia, IL
  • NPI 1669432522

  Physical Therapist

  NPD
• Amato Physical Therapy Associates, LLC

  • Physical Therapist
  • Saint Louis, MO
  • NPI 1346276607
  NPD (past)
• Babar Enterprises LLC

  • Physical Therapist
  • Creve Coeur, MO
  • NPI 1033178827
  NPD (past)

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

{
    "created_epoch": "1195603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464134400000",
    "number": "1700067436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909",
            "telephone_number": "630-296-2222",
            "fax_number": "630-759-9510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "880 COLUMBIA CTR",
            "city": "COLUMBIA",
            "state": "IL",
            "postal_code": "622362567",
            "telephone_number": "618-281-9699",
            "fax_number": "618-281-9698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNUCKLES",
        "first_name": "MELISSA",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-21",
        "last_updated": "2016-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NV",
            "license": "2192",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070021390",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MELISSA",
            "last_name": "PENBERTHY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jason Clay King, D.C.
• Michael Nels Kirk, M.D.
• Ryan William Klohr, D.M.D.
• Kimela Kluthe
• Christa Lauren Knoernschild, APRN, FNP-C
• Cathy Krebel-Nevois
• Anna Marie Kujath, PA-C
• Amy Kuliniewicz
• Laboratory Corporation of America
• Kara Patricia Lamack

• Physical Therapist in Columbia, IL
• Providers in Columbia, IL by specialty
• Physical Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2016; 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.