King Vision of Tyler LLC

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

KING VISION OF TYLER LLC

Practice address

2555 Ruby Way 8102
Paris, TX 75460

Phone

(970) 880-0011

NPI assigned

Jun 30, 2020

Organization subpart

No

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

Authorized official

Name

Rodney Jessie Jr.

Title

Manager

Phone

(970) 880-0011

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1593475200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1593475200000",
    "number": "1053938530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2555 RUBY WAY 8102",
            "city": "PARIS",
            "state": "TX",
            "postal_code": "75460",
            "telephone_number": "970-880-0011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2555 RUBY WAY 8102",
            "city": "PARIS",
            "state": "TX",
            "postal_code": "75460",
            "telephone_number": "970-880-0011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KING VISION OF TYLER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-30",
        "last_updated": "2020-06-30",
        "certification_date": "2020-06-30",
        "status": "A",
        "authorized_official_last_name": "JESSIE JR.",
        "authorized_official_first_name": "RODNEY",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "970-880-0011"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Khalid Shafiq, M.D. , P.a.
• Kidney Disease and Dialysis Associates, PA
• Kids Clinic of Paris LLC
• Kids Clinic of Paris, LLC
• Terry Lynn Kilgore, M.D.
• Christopher Kirby
• Don Kirkpatrick
• Ladonna Sue Koehn
• Timothy Koenig Jr., R.PH.
• Kroger Texas L P

• Community Based Hospice Care Agency in Paris, TX
• Providers in Paris, TX by specialty
• Community Based Hospice Care Agency in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.