Dale Grant Knutson

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

17931 Issued in GA

Practice address

1600 N Brown Rd
Lawrenceville, GA 30043-8141

Phone

(678) 720-3562

NPI assigned

Apr 4, 2011

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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.

• Signify Health Medical Associates, PLLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1750845863

  TN

  Medicare reassignment

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

{
    "created_epoch": "1301875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301875200000",
    "number": "1801185533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 N BROWN RD",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300438141",
            "telephone_number": "678-720-3562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 N BROWN RD",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300438141",
            "telephone_number": "678-720-3562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNUTSON",
        "first_name": "DALE",
        "middle_name": "GRANT",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-04-04",
        "last_updated": "2011-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "17931",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Andrew Knopf, MD
• Allison Knott, NP-C
• Sharifa T Knowles
• Adrinne Knox, RBT
• Eddie Lee Knox III, ATC
• Eun Young Ko, NP
• Sandra Kobsar, LPC, RPT, NCC
• Jacob E. Koch, D.D.S.
• Jessica Koch, NP-C
• Eunheh Koh, MD

• Pediatrics Physician in Lawrenceville, GA
• Providers in Lawrenceville, GA by specialty
• Pediatrics Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.