Individual provider Active NPI

Alicia D King, D.O.

  • Family Medicine Physician
  • Troy, MO
National Provider Identifier
1104860287
Registry record updated Dec 7, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2006006975 Issued in MO
Practice address
172 Professional Pkwy
Troy, MO 63379-2823
Phone
(636) 462-6106
NPI assigned
Jun 16, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 0532427 KS
Family Medicine Physician 207Q00000X 2006006975 MO Primary

Addresses

Primary practice location

172 Professional Pkwy
Troy, MO 63379-2823

Mailing address

172 Professional Pkwy
Troy, MO 63379-2823
Phone (636) 462-6106

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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 1

Enrollment IDStateProvider typePAC IDDetails
I20060418000696 MO Practitioner - Family PracticePractitioner - Emergency Medicine 8921017021 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency Physicians of St Lukes LLCGroup PAC ID 3779714142, 63 clinicians

Practice addresses (Care Compare)

232 S Woods Mell Rd
Chesterfield, MO 63017-3417

233 Clarkson Rd
Ellisville, MO 63011-2219
Phone (636) 256-8644

5551 Winghaven Blvd
100 Winghaven UC Center
O Fallon, MO 63368-3618
Phone (636) 695-2500

8857 Ladue Rd a
Saint Louis, MO 63124-2045
Phone (314) 576-8189

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92.71 of 100Reported as apm
Quality
82.25
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Physicians of St. Luke'S, LLC Family Medicine CurrentSince Aug 1, 2014 Accepting new patients
SSM St. Charles Clinic Medical Group, Inc. Family Medicine Past Accepting new patients
Physician Specialists of St Lukes LLC Family Medicine Past Accepting new patients
SSM Health Care St. Louis Past Accepting new patients

Locations

233 Clarkson Rd
Ellisville, MO 63011
Phone (636) 256-8644

5551 Winghaven Blvd
Ste 100
O Fallon, MO 63368
Phone (636) 695-2500

11550 Olive Blvd
Saint Louis, MO 63141
Phone (314) 542-7690

232 S Woods Mill Rd
Town and Country, MO 63017
Phone (314) 205-6030

Organizations & group practices 4

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": "1150416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1260144000000",
    "number": "1104860287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "172 PROFESSIONAL PKWY",
            "city": "TROY",
            "state": "MO",
            "postal_code": "633792823",
            "telephone_number": "636-462-6106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "172 PROFESSIONAL PKWY",
            "city": "TROY",
            "state": "MO",
            "postal_code": "633792823",
            "telephone_number": "636-462-6106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KING",
        "first_name": "ALICIA",
        "middle_name": "D",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-16",
        "last_updated": "2009-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KS",
            "license": "0532427",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2006006975",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Troy, MO

Sources for this page

Verify at the official NPI Registry.