Active NPI
James G King, PA
- Medical Physician Assistant
- McMinnville, TN
National Provider Identifier
1093877508
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- PA453
- Practice address
- 1012 S Chancery St
MC Minnville, TN 37110-3704 - Phone
- (931) 507-2273
- Fax
- (931) 507-2274
- NPI assigned
- Dec 14, 2006
- Last updated
- Jul 9, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | PA453 | TN | Primary |
Addresses
Primary practice location
1012 S Chancery St
MC Minnville, TN 37110-3704
Mailing address
168 13TH Ave NW
Winchester, TN 37398-1071
Phone (205) 712-3246
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found.
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA453 | TN | MD | Medical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166054400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1093877508",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "168 13TH AVE NW",
"city": "WINCHESTER",
"state": "TN",
"postal_code": "373981071",
"telephone_number": "205-712-3246",
"fax_number": "931-507-2274"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1012 S CHANCERY ST",
"city": "MC MINNVILLE",
"state": "TN",
"postal_code": "371103704",
"telephone_number": "931-507-2273",
"fax_number": "931-507-2274"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KING",
"first_name": "JAMES",
"middle_name": "G",
"name_prefix": "Prof.",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-14",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "TN",
"license": "PA453",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in McMinnville, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.