Individual provider Active NPI

Nicholas Jay King, LCSW

  • Clinical Social Worker
  • Bradenton, FL
National Provider Identifier
1063153344
Registry record updated Nov 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
18132 Issued in FL
Practice address
9050 58TH Dr E
Bradenton, FL 34202-6104
Phone
(941) 907-0525
NPI assigned
Apr 2, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 2, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 18132 FL Primary

Addresses

Primary practice location

9050 58TH Dr E
Bradenton, FL 34202-6104

Mailing address

925 Pattison Ave
Sarasota, FL 34237-8619
Phone (419) 260-0643

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240423001919 FL Practitioner - Clinical Social Worker 8123467123 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Doctor Q IncGroup PAC ID 4486849072, 9 clinicians

Practice addresses (Care Compare)

9050 58TH Dr E
Bradenton, FL 34202-6104
Phone (941) 907-0525

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
18132FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Doctor Q Inc Clinical CurrentSince Mar 6, 2024 Accepting new patients

Locations

9050 58th Dr E
Lakewood Ranch, FL 34202
Phone (941) 907-0525

Organizations & group practices 1

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": "1648857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762041600000",
    "number": "1063153344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "925 PATTISON AVE",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342378619",
            "telephone_number": "419-260-0643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9050 58TH DR E",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342026104",
            "telephone_number": "941-907-0525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KING",
        "first_name": "NICHOLAS",
        "middle_name": "JAY",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-04-02",
        "last_updated": "2025-11-02",
        "certification_date": "2025-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "18132",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bradenton, FL

Sources for this page

Verify at the official NPI Registry.