Individual provider Active NPI

Roberta L Knorr, MD

  • Pediatrics Physician
  • Spokane Valley, WA
National Provider Identifier
1720047624
Registry record updated Dec 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD00026592 Issued in WA
Practice address
15812 E Indiana Ave
Spokane Valley, WA 99216-1875
Phone
(509) 444-8200
Fax
(509) 444-8206
NPI assigned
Mar 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD00026592 WA Primary

Addresses

Primary practice location

15812 E Indiana Ave
Spokane Valley, WA 99216-1875

Mailing address

611 N Iron Bridge Way
Spokane, WA 99202-4932
Phone (509) 444-8888

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080515000187 WA Practitioner - Pediatric MedicinePractitioner - Obstetrics/Gynecology 4880687367 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD00026592WAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Association of Spokane Current Accepting new patients
Community Health Association of Spokane CurrentSince Jan 23, 2012 Accepting new patients
Community Health Association of Spokane CurrentSince Jan 23, 2012 Accepting new patients
L. Keith Hanson PLLC Past Accepting new patients
L Keith Hanson PLLC Pediatrics Past Accepting new patients
Central Washington Medical Associates Past Accepting new patients

Locations

611 N Iron Bridge Way
Spokane, WA 99202

1001 W 2nd Ave
Spokane, WA 99201
Phone (509) 835-1205

203 N Washington St
Ste 300
Spokane, WA 99201

15812 E Indiana Ave
Spokane Valley, WA 99216

15812 E Indiana Ave
Ste 101
Spokane Valley, WA 99216

Interoperability endpoints

  • Direct secure messaging: roberta.knorr.1@11411.direct.athenahealth.com

Organizations & group practices 6

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": "1142812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638403200000",
    "number": "1720047624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 N IRON BRIDGE WAY",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992024932",
            "telephone_number": "509-444-8888",
            "fax_number": "509-444-7806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15812 E INDIANA AVE",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "992161875",
            "telephone_number": "509-444-8200",
            "fax_number": "509-444-8206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNORR",
        "first_name": "ROBERTA",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-20",
        "last_updated": "2021-12-02",
        "certification_date": "2021-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WA",
            "license": "MD00026592",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane Valley, WA

Sources for this page

Verify at the official NPI Registry.