Individual provider Active NPI

Emily Knowles, PA-C

  • Physician Assistant
  • Jacksonville, FL
National Provider Identifier
1851787261
Registry record updated Sep 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA 9108047 Issued in FL
Practice address
836 Prudential Dr Ste 1405
Jacksonville, FL 32207-8340
Phone
(904) 388-7521
NPI assigned
Apr 13, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 22, 2021

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 PA 9108047 FL Primary

Addresses

Primary practice location

836 Prudential Dr Ste 1405
Jacksonville, FL 32207-8340

Mailing address

1824 King St Ste 200
Jacksonville, FL 32204-4736
Phone (904) 384-3343

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150527001331 FL Practitioner - Physician Assistant 3971823386 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA 9108047FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Physicians Medical Center, Inc. Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: emilyknowles@cvsapa.allscriptsdirect.net

Organizations & group practices 2

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": "1428883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632268800000",
    "number": "1851787261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1824 KING ST STE 200",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322044736",
            "telephone_number": "904-384-3343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "836 PRUDENTIAL DR STE 1405",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322078340",
            "telephone_number": "904-388-7521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNOWLES",
        "first_name": "EMILY",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-04-13",
        "last_updated": "2021-09-22",
        "certification_date": "2021-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA 9108047",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.