Individual provider Active NPI

James Lyle Knoll III, M.D.

  • Psychiatry Physician
  • Pagosa Springs, CO
National Provider Identifier
1700971223
Registry record updated Mar 19, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
34693 Issued in CO
Practice address
2295 Backcountry Dr.
Pagosa Springs, CO 81147
Phone
(970) 731-4262
Fax
(970) 731-4262
NPI assigned
Oct 3, 2006
Last updated
Mar 19, 2009By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 19, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Forensic Psychiatry Physician 2084F0202X C53409 CA
Psychiatry Physician 2084P0800X 34693 CO Primary

Addresses

Primary practice location

2295 Backcountry Dr.
Pagosa Springs, CO 81147

Mailing address

2295 Backcountry Dr.
Pagosa Springs, CO 81147
Phone (970) 731-4262

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
53409CAMDGeneral Practice Dentistry
C53409CAMDForensic Psychiatry Physician
34693COMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Colorado West Regional Mental Health, Inc. Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: jknoll26786@direct.peacehealth.org

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1237420800000",
    "number": "1700971223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2295 BACKCOUNTRY DR.",
            "city": "PAGOSA SPRINGS",
            "state": "CO",
            "postal_code": "81147",
            "telephone_number": "970-731-4262",
            "fax_number": "970-731-4262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2295 BACKCOUNTRY DR.",
            "city": "PAGOSA SPRINGS",
            "state": "CO",
            "postal_code": "81147",
            "telephone_number": "970-731-4262",
            "fax_number": "970-731-4262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNOLL",
        "first_name": "JAMES",
        "middle_name": "LYLE",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2009-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084F0202X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Forensic Psychiatry",
            "state": "CA",
            "license": "C53409",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CO",
            "license": "34693",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pagosa Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2009; 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.