Organization Active NPI

Knox Surgical LLC

  • Surgery Physician
  • Mount Vernon, OH
National Provider Identifier
1861681553
Registry record updated Mar 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
35054121 Issued in OH
Legal business name
KNOX SURGICAL LLC
Practice address
307 Vernedale Dr
Mount Vernon, OH 43050-2921
Phone
(740) 397-4430
Fax
(740) 397-8278
NPI assigned
Oct 18, 2007
Last updated
Mar 6, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2008

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

Authorized official

Name
Dr. David F Kasserman, MDNPI 1427127000
Title
Surgeon
Phone
(740) 397-4430

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 35054121 OH Primary

Addresses

Primary practice location

307 Vernedale Dr
Mount Vernon, OH 43050-2921

Mailing address

307 Vernedale Dr
Mount Vernon, OH 43050-2921
Phone (740) 397-4430

Other identifiers 1

IdentifierTypeStateIssuer
0821098MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080304000461 OH Part B Supplier - Clinic/Group Practice 7113810417 Receives reassigned benefits from 1 practitioner
Practice locations: Columbus, OH

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1192665600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204761600000",
    "number": "1861681553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "307 VERNEDALE DR",
            "city": "MOUNT VERNON",
            "state": "OH",
            "postal_code": "430502921",
            "telephone_number": "740-397-4430",
            "fax_number": "740-397-8278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "307 VERNEDALE DR",
            "city": "MOUNT VERNON",
            "state": "OH",
            "postal_code": "430502921",
            "telephone_number": "740-397-4430",
            "fax_number": "740-397-8278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KNOX SURGICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-18",
        "last_updated": "2008-03-06",
        "status": "A",
        "authorized_official_last_name": "KASSERMAN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "SURGEON",
        "authorized_official_telephone_number": "740-397-4430",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "OH",
            "license": "35054121",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0821098",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Vernon, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.