Individual provider Active NPI

Kevin Richard King, MD

  • Hospitalist Physician
  • Phenix City, AL
National Provider Identifier
1104808294
Registry record updated Apr 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
42356 Issued in AL
Practice address
4401 Riverchase Dr
Phenix City, AL 36867-7483
Phone
(334) 732-3000
Fax
(706) 494-3008
NPI assigned
Nov 15, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 056310 GA
Hospitalist Physician 208M00000X 42356 AL Primary

Addresses

Primary practice location

4401 Riverchase Dr
Phenix City, AL 36867-7483

Mailing address

PO Box 370
Fortson, GA 31808-0370
Phone (706) 494-3072

Other identifiers 1

IdentifierTypeStateIssuer
633050776EMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, AL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20050818000207 GA Practitioner - Family Practice 1658327374 Reassigns benefits to 1 organization
I20210614001021 AL Practitioner - Internal Medicine 1658327374 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Medical College of Ohio, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Internal Medicine Associates P.C.Group PAC ID 0941251607, 40 clinicians

Practice addresses (Care Compare)

121 N 20TH St
Suite 6
Opelika, AL 36801-5454
Phone (334) 749-3385

Hospital & facility affiliations

  • The East Alabama Healthcare Authority Hospital, Opelika, AL, CCN 010029

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
056310GAMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Francis Physician Practices LLC Current Accepting new patients
St Francis Physician Practices LLC CurrentSince Feb 19, 2018 Accepting new patients
Internal Medicine Associates P.C. CurrentSince Jul 1, 2021 Accepting new patients
St. Francis Physician Practices LLC CurrentSince Feb 19, 2018 Accepting new patients
Internal Medicine Lab. Current Accepting new patients
The East Alabama Health Care Authority Past Accepting new patients

Locations

121 N 20th St
Ste 6
Opelika, AL 36801
Phone (334) 749-3385

2122 Manchstr Expy
Columbus, GA 31904
Phone (706) 320-3128

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 and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1132012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618185600000",
    "number": "1104808294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 370",
            "city": "FORTSON",
            "state": "GA",
            "postal_code": "318080370",
            "telephone_number": "706-494-3072",
            "fax_number": "706-494-3008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4401 RIVERCHASE DR",
            "city": "PHENIX CITY",
            "state": "AL",
            "postal_code": "368677483",
            "telephone_number": "334-732-3000",
            "fax_number": "706-494-3008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KING",
        "first_name": "KEVIN",
        "middle_name": "RICHARD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-15",
        "last_updated": "2021-04-12",
        "certification_date": "2021-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "GA",
            "license": "056310",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "AL",
            "license": "42356",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "633050776E",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phenix City, AL

Sources for this page

Verify at the official NPI Registry.