Individual provider Active NPI

Kevin McKnight, ATC

  • Athletic Trainer
  • West Creek, NJ
National Provider Identifier
1962833087
Registry record updated Nov 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
25MT00031 Issued in NJ
Practice address
646 Main St
West Creek, NJ 08092-9757
Phone
(732) 785-3000
NPI assigned
Nov 30, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 30, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 25MT00031 NJ Primary

Addresses

Primary practice location

646 Main St
West Creek, NJ 08092-9757

Mailing address

646 Main St
West Creek, NJ 08092-9757
Phone (732) 785-3000

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

LicenseStateTypeSpecialty
25MT00031NJMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1385769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1385769600000",
    "number": "1962833087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "646 MAIN ST",
            "city": "WEST CREEK",
            "state": "NJ",
            "postal_code": "080929757",
            "telephone_number": "732-785-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "646 MAIN ST",
            "city": "WEST CREEK",
            "state": "NJ",
            "postal_code": "080929757",
            "telephone_number": "732-785-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKNIGHT",
        "first_name": "KEVIN",
        "credential": "ATC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-11-30",
        "last_updated": "2013-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NJ",
            "license": "25MT00031",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Creek, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2013; 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.