Kingdom Medical Services LLC

Primary specialty

Portable X-ray and/or Other Portable Diagnostic Imaging SupplierTaxonomy code 335V00000X

Legal business name

KINGDOM MEDICAL SERVICES LLC

Practice address

2770 Main St Ste 164
Frisco, TX 75033-4385

Phone

(469) 269-6894

NPI assigned

Mar 19, 2021

Organization subpart

No

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

Authorized official

Name

Jason Johnson

Title

Owner

Phone

(913) 387-9538

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Tax ID family

Kingdom Medical Services2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Kingdom Medical Services

  • Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
  • Frisco, TX
  • NPI 1093410300
  NPD tax ID

Locations

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

{
    "created_epoch": "1616112000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682294400000",
    "number": "1073199246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2770 MAIN ST STE 164",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750334385",
            "telephone_number": "469-269-6894",
            "fax_number": "469-299-4546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2770 MAIN ST STE 164",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750334385",
            "telephone_number": "469-269-6894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KINGDOM MEDICAL SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-19",
        "last_updated": "2023-04-24",
        "certification_date": "2023-04-24",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "913-387-9538"
    },
    "taxonomies": [
        {
            "code": "335V00000X",
            "taxonomy_group": "",
            "desc": "Portable X-ray and/or Other Portable Diagnostic Imaging Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard V King, MA, MMED, PHD
• Taylor Denise King, MHS
• Vanessa Latisa King, LMSW
• Kingcolby PLLC
• Kingdom Medical Services
• Brooke Lee Kinikini, BCABA
• Julia Caroline Kirby, MBBS
• Shannan Kirchner, OTR
• Georgia Anastasia Kiriakos
• Madeline Kirk, M.S., CCC-SLP

• Portable X-ray and/or Other Portable Diagnostic Imaging Supplier in Frisco, TX
• Providers in Frisco, TX by specialty
• Portable X-ray and/or Other Portable Diagnostic Imaging Supplier in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.