Charlene Davis King, DNP, FPMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

R839684 Issued in MS

Practice address

713 Farmer St
Port Gibson, MS 39150-2319

Phone

(601) 448-5176

Fax

(601) 448-5197

NPI assigned

Jul 11, 2006

Last updated

Jan 22, 2016By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Kings Psychiatric Services LLC

  dba Charlene D King

  • Psychiatric/Mental Health Nurse Practitioner
  • Port Gibson, MS
  • NPI 1023449329
  Authorized official Same address or phone
• Magnolia Counseling

  • Specialist
  • Batesville, MS
  • NPI 1891919668
  NPD (past)
• South Mississippi Health Service, Inc

  dba South Mississippi Psychiatric Group

  • Psychiatry Physician
  • Hattiesburg, MS
  • NPI 1447356902

  Psychiatric/Mental Health

  NPD (past)

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453420800000",
    "number": "1104851161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "713 FARMER ST",
            "city": "PORT GIBSON",
            "state": "MS",
            "postal_code": "391502319",
            "telephone_number": "601-448-5176",
            "fax_number": "601-448-5197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "713 FARMER ST",
            "city": "PORT GIBSON",
            "state": "MS",
            "postal_code": "391502319",
            "telephone_number": "601-448-5176",
            "fax_number": "601-448-5197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KING",
        "first_name": "CHARLENE",
        "middle_name": "DAVIS",
        "name_prefix": "Mrs.",
        "credential": "DNP, FPMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-11",
        "last_updated": "2016-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MS",
            "license": "R839684",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05207250",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "455325",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Janie Epps Harris, PCMHT, PH6042
• David McCaa Headley, MD
• Arlene Hunt, FNP
• Lasalle Jackson
• Dorothy Jeanette Jones
• Kings Psychiatric Services LLC (Charlene D King)
• Stuart P Leventhal, MD
• Annette Jeannie Louis, REGISTERED NURSE
• Demetri W Marshall, M.D.
• Mississippi State Department of Health

• Psychiatric/Mental Health Nurse Practitioner in Port Gibson, MS
• Providers in Port Gibson, MS by specialty
• Psychiatric/Mental Health Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2016; 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.