Individual provider Active NPI

Katelynn Knipper, PAC

  • Physician Assistant
  • Dubuque, IA
National Provider Identifier
1700452117
Registry record updated Nov 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
107503 Issued in IA
Practice address
535 Cedar Cross Rd
Dubuque, IA 52003-7704
Phone
(563) 588-0506
NPI assigned
May 27, 2021
Last updated
Nov 16, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 107503 IA Primary
Surgical Physician Assistant 363AS0400X 5437-23 WI

Addresses

Primary practice location

535 Cedar Cross Rd
Dubuque, IA 52003-7704

Mailing address

535 Cedar Cross Rd
Dubuque, IA 52003-7704
Phone (563) 588-0506

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221123000453 IA Practitioner - Physician Assistant 1355741661 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Unified Therapy Services, IncGroup PAC ID 7618985714, 124 clinicians
Dubuque ENT Head and Neck Surgery PCGroup PAC ID 8426947607, 5 clinicians

Practice addresses (Care Compare)

4135 Pennsylvania Ave
Dubuque, IA 52002-2628

535 Cedar Cross Rd
Dubuque, IA 52003-7704
Phone (563) 588-0506

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
107503IAMDPhysician Assistant
5437-23WIMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
St Luke's Methodist Hospital Current Accepting new patients
The Finley Hospital Physician Assistant Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: kknipper829173@direct.unitypoint.org

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1622073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668556800000",
    "number": "1700452117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "535 CEDAR CROSS RD",
            "city": "DUBUQUE",
            "state": "IA",
            "postal_code": "520037704",
            "telephone_number": "563-588-0506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "535 CEDAR CROSS RD",
            "city": "DUBUQUE",
            "state": "IA",
            "postal_code": "520037704",
            "telephone_number": "563-588-0506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNIPPER",
        "first_name": "KATELYNN",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-27",
        "last_updated": "2022-11-16",
        "certification_date": "2022-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IA",
            "license": "107503",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "WI",
            "license": "5437-23",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dubuque, IA

Sources for this page

Verify at the official NPI Registry.