Jon Francis Knickrehm, D.O.

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

DO-596 Issued in AL

Practice address

12511 World Plaza LN BLDG 50
Fort Myers, FL 33907-3991

Phone

(239) 939-2622

Fax

(239) 939-0151

NPI assigned

Jan 4, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Sentry Anesthesia Management, LLC

  • Anesthesiology Physician
  • Newnan, GA
  • NPI 1134544794
  Medicare reassignment NPD

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

{
    "created_epoch": "1136332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361923200000",
    "number": "1891773552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10201 AVALON LAKE CIR",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "33913",
            "telephone_number": "239-768-7171",
            "fax_number": "239-939-0151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12511 WORLD PLAZA LN BLDG 50",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339073991",
            "telephone_number": "239-939-2622",
            "fax_number": "239-939-0151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNICKREHM",
        "first_name": "JON",
        "middle_name": "FRANCIS",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-04",
        "last_updated": "2013-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "AL",
            "license": "DO-596",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "276018500",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC BS FL",
            "identifier": "56478",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00343579",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John Peter Kmetz, P.A.
• Mila Kmezic, M.D.
• Knap Inc.
• Knap Inc.
• Michael Donald Knecht
• Staci Fleischer Knickrehm, DO
• Karen Knific, ARNP
• Randolph J Knific, MD
• Barbara C Knight, MD
• Chevonne Olivia Knight

• Anesthesiology Physician in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Anesthesiology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.