Active NPI
Judith Ann McKnight, OTR
- Mental Health Occupational Therapist
- Fort Gordon, GA
National Provider Identifier
1790969095
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Occupational Therapist
- License
- OT002730
- Practice address
- 300 East Hospital Road
Fort Gordon, GA 30905-0000 - Phone
- (706) 504-7105
- NPI assigned
- Dec 21, 2007
- Last updated
- Mar 22, 2023
- 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 |
|---|---|---|---|---|
| Mental Health Occupational Therapist | 225XM0800X | OT002730 | GA | Primary |
Addresses
Primary practice location
300 East Hospital Road
Fort Gordon, GA 30905-0000
Mailing address
2493 William Few Pkwy
Evans, GA 30809-7436
Phone (706) 504-7105
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 |
|---|---|---|---|
| OT002730 | GA | MD | Mental Health Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| In Home Pediatric Therapy Inc | Pediatrics | Past | Accepting new patients |
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": "1198195200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1679443200000",
"number": "1790969095",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2493 WILLIAM FEW PKWY",
"city": "EVANS",
"state": "GA",
"postal_code": "308097436",
"telephone_number": "706-504-7105"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 EAST HOSPITAL ROAD",
"city": "FORT GORDON",
"state": "GA",
"postal_code": "309050000",
"telephone_number": "706-504-7105"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCKNIGHT",
"first_name": "JUDITH",
"middle_name": "ANN",
"name_prefix": "Mrs.",
"credential": "OTR",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-12-21",
"last_updated": "2023-03-22",
"certification_date": "2023-03-20",
"status": "A"
},
"taxonomies": [
{
"code": "225XM0800X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Mental Health",
"state": "GA",
"license": "OT002730",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Fort Gordon, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.