Active NPI
Katharine Meldrum Knicely, OTR
- Specialist
- Shreveport, LA
National Provider Identifier
1881907624
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- OTT.200401
- Practice address
- 416 Braemar Rd
Shreveport, LA 71106-8534 - Phone
- (318) 393-3360
- NPI assigned
- Jul 21, 2010
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | OTT.200401 | LA | Primary |
Addresses
Primary practice location
416 Braemar Rd
Shreveport, LA 71106-8534
Mailing address
PO Box 6357
Shreveport, LA 71136-6357
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OTT.200401 | LA | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1279670400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1699574400000",
"number": "1881907624",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 6357",
"city": "SHREVEPORT",
"state": "LA",
"postal_code": "711366357"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "416 BRAEMAR RD",
"city": "SHREVEPORT",
"state": "LA",
"postal_code": "711068534",
"telephone_number": "318-393-3360"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KNICELY",
"first_name": "KATHARINE",
"middle_name": "MELDRUM",
"credential": "OTR",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-07-21",
"last_updated": "2023-11-10",
"certification_date": "2023-11-10",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "LA",
"license": "OTT.200401",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Shreveport, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.