Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Peter Ford Knickerbocker, DO

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1336432608

Peter Ford Knickerbocker, DO is a Pediatric Medicine in Jacksonville, Florida. Graduated from Philadelphia College of Osteopathic Medicine in 2011, 15 years ago. Practices with Southern California Permanente Medical Group, an 11,242-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
15
Trained at
Philadelphia College of Osteopathic Medicine
Licensed in
CA
In the registry since
2011
Specialties on file
2
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

See every abbreviation used in this directory →

Claim this listing Report a problem Suggest an edit

Practice location Address checks out

Bldg H 2005 Knight Lane Navy Medicine Support Command
Jacksonville, FL 32212-0140
Phone: (215) 298-2476
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Neonatal-Perinatal Medicine Physician (primary) Taxonomy 2080N0001X · Licence 20A12420 (CA)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1336432608
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorNo
NPI enumeratedMay 19, 2011
Last updated in NPPESMarch 23, 2023
Certification dateMarch 23, 2023
Mailing address3435 Gurnard Ct, San Diego, CA 92124-3304

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPEDIATRIC MEDICINE
Medical schoolPHILADELPHIA COLLEGE OF OSTEOPATHIC MEDICINE
Graduated 2011 (15 years in practice)
Group practice Southern California Permanente Medical Group — 11242 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Jacksonville