Individual provider Active NPI

Jimmie Sue Knight, RN, PHN, IBCLC

  • Lactation Consultant (Registered Nurse)
  • Morgan Hill, CA
National Provider Identifier
1780865485
Registry record updated Jul 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Lactation Consultant (Registered Nurse)Taxonomy code 163WL0100X
License
692825 Issued in CA
Practice address
15880 El Pajaro CT
Morgan Hill, CA 95037-5640
Phone
(408) 859-1490
NPI assigned
Nov 21, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 16, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Registered Nurse 163WC0400X 692825 CA
Lactation Consultant (Registered Nurse) 163WL0100X 692825 CA Primary

Addresses

Primary practice location

15880 El Pajaro CT
Morgan Hill, CA 95037-5640

Mailing address

15880 El Pajaro CT
Morgan Hill, CA 95037-5640
Phone (408) 859-1490

Other practice location 1

80 Highland Ave
San Martin, CA 95046-9504
Phone (408) 683-1232

Other names 1

  • Jimmie Sue Clark Former name

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
692825CAMDCase Management Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1195603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563235200000",
    "number": "1780865485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15880 EL PAJARO CT",
            "city": "MORGAN HILL",
            "state": "CA",
            "postal_code": "950375640",
            "telephone_number": "408-859-1490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15880 EL PAJARO CT",
            "city": "MORGAN HILL",
            "state": "CA",
            "postal_code": "950375640",
            "telephone_number": "408-859-1490"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "80 Highland Ave",
            "address_purpose": "LOCATION",
            "city": "San Martin",
            "state": "CA",
            "postal_code": "950469504",
            "country_code": "US",
            "telephone_number": "408-683-1232",
            "fax_number": "408-683-4953",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KNIGHT",
        "first_name": "JIMMIE",
        "middle_name": "SUE",
        "name_prefix": "Ms.",
        "credential": "RN, PHN, IBCLC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-11-21",
        "last_updated": "2019-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Case Management",
            "state": "CA",
            "license": "692825",
            "primary": false
        },
        {
            "code": "163WL0100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Lactation Consultant",
            "state": "CA",
            "license": "692825",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JIMMIE",
            "last_name": "CLARK",
            "middle_name": "SUE",
            "credential": "R.N., P.H.N.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Morgan Hill, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2019; 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.