Individual provider Active NPI

Trenton E Knewtson, DO

  • Family Medicine Physician
  • Kailua Kona, HI
National Provider Identifier
1982693503
Registry record updated Jul 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
05 29059 Issued in KS
Practice address
77-311 Sunset Dr
Kailua Kona, HI 96740-9754
Phone
(808) 327-4357
NPI assigned
Oct 17, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 05 29059 KS Primary

Addresses

Primary practice location

77-311 Sunset Dr
Kailua Kona, HI 96740-9754

Mailing address

77-311 Sunset Dr
Kailua Kona, HI 96740-9754

Other identifiers 1

IdentifierTypeStateIssuer
100390630AMedicaidKS

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20201023002035 NV Practitioner - Family Practice 6507825387 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
05 29059KSMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Intermountain Medical Holdings Nevada Inc CurrentSince Mar 6, 2023 Accepting new patients
Intermountain Medical Holdings Nevada Inc Family Medicine CurrentSince Mar 6, 2023 Accepting new patients
Shawnee Mission Medical Center, Inc. Family Medicine Past Accepting new patients
Sunrise Mountainview Hospital, Inc. Past Accepting new patients
Centennial Hills Hospital Medical Center Past Accepting new patients
Dignity Health Past Accepting new patients
Desert Springs Hospital Past Accepting new patients
Trent E. Knewtson Family Medicine PastSince Jan 1, 1990 Accepting new patients
Ucxtra Umbrella, LLC PastSince Jul 17, 2020 Accepting new patients
Healthcare Partners Medical Group (Coats) LTD. Past Accepting new patients
Miami County Medical Center Inc Past Accepting new patients
Carespot Professional Services LLC PastSince Aug 4, 2015 Accepting new patients
Shawnee Mission Medical Center Inc Family Medicine Past Accepting new patients

Locations

6355 S Buffalo Dr
Fl 3
Las Vegas, NV 89113
Phone (702) 479-4881

4880 Wynn Rd
Las Vegas, NV 89103
Phone (702) 382-4554

1397 S Loop Rd
Pahrump, NV 89048
Phone (775) 727-5500

Organizations & group practices 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1129507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437523200000",
    "number": "1982693503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77-311 SUNSET DR",
            "city": "KAILUA KONA",
            "state": "HI",
            "postal_code": "967409754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77-311 SUNSET DR",
            "city": "KAILUA KONA",
            "state": "HI",
            "postal_code": "967409754",
            "telephone_number": "808-327-4357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNEWTSON",
        "first_name": "TRENTON",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-17",
        "last_updated": "2015-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KS",
            "license": "05 29059",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100390630A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kailua Kona, HI

Sources for this page

Verify at the official NPI Registry.