Active NPI
Andrew Matthew Knepp, PA-C
- Medical Physician Assistant
- Pottsville, PA
National Provider Identifier
1801992680
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- MA000665L
- Practice address
- 1410 Laurel Blvd
Community Based V.a. Clinic
Pottsville, PA 17901 - Phone
- (570) 628-5374
- Fax
- (570) 628-5809
- NPI assigned
- Sep 16, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | OA000075L | PA | |
| Medical Physician Assistant | 363AM0700X | MA000665L | PA | Primary |
Addresses
Primary practice location
1410 Laurel Blvd
Community Based V.a. Clinic
Pottsville, PA 17901
Mailing address
1611 NW 12 Avenue
Urology Department
Miami, FL 33136
Phone (305) 243-3670
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)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OA000075L | PA | MD | Physician Assistant |
| MA000665L | PA | MD | Medical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158364800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1574726400000",
"number": "1801992680",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1611 NW 12 AVENUE",
"address_2": "UROLOGY DEPARTMENT",
"city": "MIAMI",
"state": "FL",
"postal_code": "33136",
"telephone_number": "305-243-3670",
"fax_number": "305-243-4653"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1410 LAUREL BLVD",
"address_2": "COMMUNITY BASED V.A. CLINIC",
"city": "POTTSVILLE",
"state": "PA",
"postal_code": "17901",
"telephone_number": "570-628-5374",
"fax_number": "570-628-5809"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KNEPP",
"first_name": "ANDREW",
"middle_name": "MATTHEW",
"name_prefix": "Mr.",
"credential": "PA-C",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-09-16",
"last_updated": "2019-11-26",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "PA",
"license": "OA000075L",
"primary": false
},
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "PA",
"license": "MA000665L",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pottsville, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 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.