Individual provider Active NPI

Richard G King, MD

  • Family Medicine Physician
  • Madisonville, KY
National Provider Identifier
1124124128
Registry record updated Jan 26, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
22646 Issued in KY
Practice address
200 Clinic Dr
Madisonville, KY 42431-1661
Phone
(270) 825-7200
NPI assigned
Sep 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 22646 KY Primary

Addresses

Primary practice location

200 Clinic Dr
Madisonville, KY 42431-1661

Mailing address

200 Clinic Dr
Madisonville, KY 42431-1661
Phone (270) 825-7200

Other identifiers 3

IdentifierTypeStateIssuer
000000044259OtherBCBS PROVIDER NUMBER
64226467MedicaidKY
22646OtherKYLICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20150113001243 KY Order and Referring Only - Family PracticePractitioner - Family Practice 9830230929

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
22646KYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ohio Valley Neurology LLC Current Accepting new patients

Locations

200 Clinic Dr
Madisonville, KY 42431
Phone (270) 821-8874

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1158364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264464000000",
    "number": "1124124128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 CLINIC DR",
            "city": "MADISONVILLE",
            "state": "KY",
            "postal_code": "424311661",
            "telephone_number": "270-825-7200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 CLINIC DR",
            "city": "MADISONVILLE",
            "state": "KY",
            "postal_code": "424311661",
            "telephone_number": "270-825-7200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KING",
        "first_name": "RICHARD",
        "middle_name": "G",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-16",
        "last_updated": "2010-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "22646",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NUMBER",
            "identifier": "000000044259",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64226467",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "22646",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Madisonville, KY

Sources for this page

Verify at the official NPI Registry.