Individual provider Active NPI

Gregory Paul Kniss, D.O.

  • Preventive Medicine/Occupational Environmental Medicine Physician
  • Fort Wayne, IN
National Provider Identifier
1821008574
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Preventive Medicine/Occupational Environmental Medicine PhysicianTaxonomy code 2083P0500X
License
02001648 Issued in IN
Practice address
9318 Airport Dr
Fort Wayne, IN 46809-3047
Phone
(260) 373-9330
Fax
(260) 373-9340
NPI assigned
Aug 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Preventive Medicine/Occupational Environmental Medicine Physician 2083P0500X 02001648 IN Primary

Addresses

Primary practice location

9318 Airport Dr
Fort Wayne, IN 46809-3047

Mailing address

3103 E State Blvd
Fort Wayne, IN 46805-4738
Phone (260) 373-9300

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
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
02001648INMDPreventive Medicine/Occupational Environmental Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Redimed Dekalb LLC Past Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
Parkview Health System Inc Past Accepting new patients
St. Joseph Health System, LLC Past Accepting new patients
Parkview Hospital, Inc. Past Accepting new patients

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1821008574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3103 E STATE BLVD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468054738",
            "telephone_number": "260-373-9300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9318 AIRPORT DR",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468093047",
            "telephone_number": "260-373-9330",
            "fax_number": "260-373-9340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNISS",
        "first_name": "GREGORY",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083P0500X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine",
            "state": "IN",
            "license": "02001648",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.