NPIMap

Individual provider Active NPI

Shelby Laine Knox, PA

  • Physician Assistant
  • Tioga, ND
National Provider Identifier
1801317417
Registry record updated Jan 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0886 Issued in ND
Practice address
810 N Welo St
Tioga, ND 58852-7157
Phone
(701) 664-3305
Fax
(701) 664-2240
NPI assigned
Jul 5, 2017
Last updated
Jan 24, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 24, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0886 ND Primary

Addresses

Primary practice location

810 N Welo St
Tioga, ND 58852-7157

Mailing address

810 N Welo St
Tioga, ND 58852-7157
Phone (701) 664-3305

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20170727000659 ND Practitioner - Physical Therapist in Private Practice 6608146477 Reassigns benefits to 1 organization
I20210812003957 ND Practitioner - Physician Assistant 6608146477 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tioga Medical CenterGroup PAC ID 1254390305, shared by 7 NPIs, 10 clinicians

Practice addresses (Care Compare)

810 N Welo St
Tioga, ND 58852-7157
Phone (701) 664-3305

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0886NDMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Tioga Medical Center CurrentSince Aug 1, 2022 Accepting new patients
Tioga Medical Center CurrentSince Jul 7, 2021 Accepting new patients
Live in Motion Physical Therapy Specialists, PLLC Physical Therapist CurrentSince Jul 10, 2017 Accepting new patients
Tioga Medical Center Past Accepting new patients

Locations

1502 13th Ave W
Ste 101
Williston, ND 58801
Phone (701) 651-4325

Organizations & group practices 4

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.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1499212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706054400000",
    "number": "1801317417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "810 N WELO ST",
            "city": "TIOGA",
            "state": "ND",
            "postal_code": "588527157",
            "telephone_number": "701-664-3305",
            "fax_number": "701-664-2240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 N WELO ST",
            "city": "TIOGA",
            "state": "ND",
            "postal_code": "588527157",
            "telephone_number": "701-664-3305",
            "fax_number": "701-664-2240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNOX",
        "first_name": "SHELBY",
        "middle_name": "LAINE",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-07-05",
        "last_updated": "2024-01-24",
        "certification_date": "2024-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ND",
            "license": "0886",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tioga, ND

Sources for this page

Verify at the official NPI Registry.