Individual provider Active NPI

David Charles King, MD

  • Occupational Medicine Physician
  • Post Falls, ID
National Provider Identifier
1043204100
Registry record updated Mar 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Medicine PhysicianTaxonomy code 2083X0100X
License
M-14451 Issued in ID
Practice address
750 N Syringa St Ste 100
Post Falls, ID 83854-5275
Phone
(208) 262-2348
Fax
(208) 457-0015
NPI assigned
Sep 6, 2005
Last updated
Mar 16, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X M-14451 ID
Orthopaedic Surgery Physician 207X00000X M-14451 ID
Occupational Medicine Physician 2083X0100X M-14451 ID Primary

Addresses

Primary practice location

750 N Syringa St Ste 100
Post Falls, ID 83854-5275

Mailing address

1593 E Polston Ave
Post Falls, ID 83854-5326
Phone (208) 262-2348

Other practice location 1

315 W Dalton Ave Ste A
Coeur D Alene, ID 83815-8600
Phone (208) 262-2348

Other identifiers 2

IdentifierTypeStateIssuer
1043204100MedicaidID
1090659MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
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
I20070130000581 ID Practitioner - Preventive MedicinePractitioner - Orthopedic Surgery 9638163884 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
M-14451IDMDOccupational Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Idaho Day Surgery LLC CurrentSince Dec 3, 2018 Accepting new patients
Theron C Tilgner D O LLC Orthopaedic Surgery CurrentSince Oct 1, 2012 Accepting new patients
Downtown Orthopedics, P.a. Orthopaedic Surgery Past Accepting new patients
North Idaho Day Surgery LLC Past Accepting new patients
Wythe County Physician Practices LLC Past Accepting new patients
Venia, PLLC PastSince Jan 1, 2005 Accepting new patients

Locations

297 Lake Havasu Ave S
Ste 108
Lk Havasu Cty, AZ 86403
Phone (928) 854-3333

1713 S Kofa Ave
Ste F
Parker, AZ 85344
Phone (520) 669-1666

7173 E Super 1 Loop
Ste A
Athol, ID 83801
Phone (208) 561-9970

315 W Dalton Ave
Ste A
Coeur D Alene, ID 83815
Phone (208) 209-2060

1593 E Polston Ave
Post Falls, ID 83854
Phone (208) 262-2300

750 N Syringa St
Ste 100
Post Falls, ID 83854
Phone (208) 262-2600

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1125964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584316800000",
    "number": "1043204100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1593 E POLSTON AVE",
            "city": "POST FALLS",
            "state": "ID",
            "postal_code": "838545326",
            "telephone_number": "208-262-2348",
            "fax_number": "208-457-0015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 N SYRINGA ST STE 100",
            "city": "POST FALLS",
            "state": "ID",
            "postal_code": "838545275",
            "telephone_number": "208-262-2348",
            "fax_number": "208-457-0015"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "315 W Dalton Ave Ste A",
            "address_purpose": "LOCATION",
            "city": "Coeur D Alene",
            "state": "ID",
            "postal_code": "838158600",
            "country_code": "US",
            "telephone_number": "208-262-2348",
            "fax_number": "208-457-0015",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KING",
        "first_name": "DAVID",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-06",
        "last_updated": "2020-03-16",
        "certification_date": "2020-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "ID",
            "license": "M-14451",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "ID",
            "license": "M-14451",
            "primary": false
        },
        {
            "code": "2083X0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Occupational Medicine",
            "state": "ID",
            "license": "M-14451",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1043204100",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1090659",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Post Falls, ID

Sources for this page

Verify at the official NPI Registry.