Healthcare Provider Details

I. General information

NPI: 1013635523
Provider Name (Legal Business Name): CHRISTOPHER KNIPE PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/19/2022
Last Update Date: 12/30/2024
Certification Date: 12/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2600 TARAWA CT
VIRGINIA BEACH VA
23459-9235
US

IV. Provider business mailing address

1110 OCEAN PEBBLES WAY
VIRGINIA BEACH VA
23451-6540
US

V. Phone/Fax

Practice location:
  • Phone: 860-694-4123
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171000000X
TaxonomyMilitary Health Care Provider
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2865M2000X
TaxonomyMilitary General Acute Care Hospital
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: