Active NPI
Ray H King, M.D.
- Family Medicine Physician
- Jackson, MI
National Provider Identifier
1104868371
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 4301045040
- Practice address
- 400 Hinckley Blvd
Suite 100
Jackson, MI 49203-6125 - Phone
- (517) 784-0588
- Fax
- (517) 784-3866
- NPI assigned
- Jun 12, 2006
- Last updated
- Dec 9, 2011
- 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 4301045040 | MI | Primary |
Addresses
Primary practice location
400 Hinckley Blvd
Suite 100
Jackson, MI 49203-6125
Mailing address
PO Box 67000
Department 272801
Detroit, MI 48267-0002
Phone (517) 841-6913
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4301045040 | MI | MD | Family Medicine Physician |
Interoperability endpoints
- rking453925@direct.hfhs.org
Organizations & group practices 1
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.
-
- Family Medicine Physician
- Jackson, MI
- NPI 1437100674
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150070400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1323388800000",
"number": "1104868371",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 67000",
"address_2": "DEPARTMENT 272801",
"city": "DETROIT",
"state": "MI",
"postal_code": "482670002",
"telephone_number": "517-841-6913",
"fax_number": "517-841-6917"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "400 HINCKLEY BLVD",
"address_2": "SUITE 100",
"city": "JACKSON",
"state": "MI",
"postal_code": "492036125",
"telephone_number": "517-784-0588",
"fax_number": "517-784-3866"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KING",
"first_name": "RAY",
"middle_name": "H",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-12",
"last_updated": "2011-12-09",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MI",
"license": "4301045040",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Jackson, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.