Individual provider Active NPI

William Scott King Jr., MD

  • Surgery Physician
  • Memphis, TN
National Provider Identifier
1104936475
Registry record updated Mar 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
8918 Issued in TN
Practice address
6029 Walnut Grove Rd
Suite 404
Memphis, TN 38120-2112
Phone
(901) 726-1056
Fax
(901) 726-5867
NPI assigned
Aug 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 8918 TN Primary

Addresses

Primary practice location

6029 Walnut Grove Rd
Suite 404
Memphis, TN 38120-2112

Mailing address

6029 Walnut Grove Rd
Suite 404
Memphis, TN 38120-2112
Phone (901) 726-1056

Other identifiers 2

IdentifierTypeStateIssuer
760000221OtherTNRAILROAD MEDICARE
3168996MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20051005001018 TN Practitioner - General Surgery 1557396843

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
8918TNMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Francis Physician Network, LLC CurrentSince Feb 5, 2018 Accepting new patients
Eric Blakney Current Accepting new patients

Locations

2996 Kate Bond Rd
Ste 309
Bartlett, TN 38133
Phone (901) 722-9943

6029 Walnut Grove Rd
Ste 404
Memphis, TN 38120

6005 Park Ave
Ste 601
Memphis, TN 38119
Phone (901) 680-9205

6005 Park Ave
Ste 323B
Memphis, TN 38119
Phone (901) 756-6991

452 Perkins Ext
Memphis, TN 38117
Phone (901) 730-8300

5959 Park Ave
Memphis, TN 38119
Phone (901) 765-1000

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1269820800000",
    "number": "1104936475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6029 WALNUT GROVE RD",
            "address_2": "SUITE 404",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381202112",
            "telephone_number": "901-726-1056",
            "fax_number": "901-726-5867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6029 WALNUT GROVE RD",
            "address_2": "SUITE 404",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381202112",
            "telephone_number": "901-726-1056",
            "fax_number": "901-726-5867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KING",
        "first_name": "WILLIAM",
        "middle_name": "SCOTT",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2010-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TN",
            "license": "8918",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "760000221",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3168996",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.