Individual provider Active NPI

Kathleen Elizabeth Knudson, MD

  • Neurological Surgery Physician
  • Greenville, NC
National Provider Identifier
1992062269
Registry record updated Dec 31, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
2020-02621 Issued in NC
Practice address
2325 Stantonsburg Rd
Greenville, NC 27834-7534
Phone
(252) 847-1550
NPI assigned
Apr 11, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 31, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X DC
Neurological Surgery Physician 207T00000X 2020-02621 NC Primary

Addresses

Primary practice location

2325 Stantonsburg Rd
Greenville, NC 27834-7534

Mailing address

2325 Stantonsburg Rd
Greenville, NC 27834-7534

Other practice location 1

2150 Pennsylvania Ave NW
Washington, DC 20037-3201
Phone (202) 741-3000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kknudson302128@direct.vidanthealth.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, NY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20200713000866 NC Practitioner - Neurosurgery 2567885320 Reassigns benefits to 1 organization
I20240912002255 NY Practitioner - Neurosurgery 2567885320 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurosurgery
Education
Clvlnd Clinic Lerner College of Med of Case WSTN RSV University, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Upstate Neurosurgery LLPGroup PAC ID 0042271520, 15 clinicians

Practice addresses (Care Compare)

90 Presidential PLZ
Syracuse, NY 13202-2240
Phone (315) 464-4470

Merit-based Incentive Payment System (MIPS)

Final score
96.95 of 100Reported as apm
Quality
82.44
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
332504NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Vidant Medical Group LLC CurrentSince Jul 6, 2020 Accepting new patients
Upstate Neurosurgery LLP Neurological Surgery CurrentSince Sep 1, 2024 Accepting new patients
Neurosurgical Associates of Central New York, LLP CurrentSince Sep 1, 2024 Accepting new patients
Vidant Medical Group LLC CurrentSince Jul 6, 2020 Accepting new patients
Suny Health Science Center at Syracuse Past Accepting new patients

Locations

2100 Stantonsburg Rd
Greenville, NC 27834
Phone (252) 744-3229

2325 Stantonsburg Rd
Greenville, NC 27834
Phone (252) 752-5156

401 N Main St
Kenansville, NC 28349
Phone (910) 296-0941

90 Presidential Plz
Syracuse, NY 13202
Phone (315) 464-3836

4900 Broad Rd
Ste 1352
Syracuse, NY 13215
Phone (315) 464-4470

90 Presidential Plz
Fl 290
Syracuse, NY 13202

Interoperability endpoints

  • Direct secure messaging: kknudson158797@direct.upstate.edu

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1334102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609372800000",
    "number": "1992062269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2325 STANTONSBURG RD",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278347534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2325 STANTONSBURG RD",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278347534",
            "telephone_number": "252-847-1550"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2150 Pennsylvania Ave NW",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "200373201",
            "country_code": "US",
            "telephone_number": "202-741-3000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KNUDSON",
        "first_name": "KATHLEEN",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-04-11",
        "last_updated": "2020-12-31",
        "certification_date": "2020-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "DC",
            "license": null,
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "NC",
            "license": "2020-02621",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kknudson302128@direct.vidanthealth.com",
            "affiliation": "N",
            "address_1": "2100 Stantonsburg Rd",
            "city": "Greenville",
            "state": "NC",
            "country_code": "US",
            "postal_code": "278342818",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Greenville, NC

Sources for this page

Verify at the official NPI Registry.