Active NPI
Kimberly Wheeler Knudsen, OT
- Community Health Worker
- Pensacola, FL
National Provider Identifier
1720386691
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Health Worker
- License
- OT10609
- Practice address
- 2310 Abbie LN
Pensacola, FL 32514-5983 - Phone
- (850) 505-9989
- Fax
- (850) 505-9990
- NPI assigned
- Mar 2, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Health Worker | 172V00000X | OT10609 | FL | Primary |
Addresses
Primary practice location
2310 Abbie LN
Pensacola, FL 32514-5983
Mailing address
2310 Abbie LN
Pensacola, FL 32514-5983
Phone (850) 505-9989
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| FL OT10609 | Other | FL | FL STATE LICENSE |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OT10609 | FL | MD | Community Health Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1299024000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1299024000000",
"number": "1720386691",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2310 ABBIE LN",
"city": "PENSACOLA",
"state": "FL",
"postal_code": "325145983",
"telephone_number": "850-505-9989",
"fax_number": "850-505-9990"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2310 ABBIE LN",
"city": "PENSACOLA",
"state": "FL",
"postal_code": "325145983",
"telephone_number": "850-505-9989",
"fax_number": "850-505-9990"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KNUDSEN",
"first_name": "KIMBERLY",
"middle_name": "WHEELER",
"credential": "OT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-03-02",
"last_updated": "2011-03-02",
"status": "A"
},
"taxonomies": [
{
"code": "172V00000X",
"taxonomy_group": "",
"desc": "Community Health Worker",
"state": "FL",
"license": "OT10609",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FL STATE LICENSE",
"identifier": "FL OT10609",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Pensacola, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.