Philip Crighton King III, AUD

Primary specialty

AudiologistTaxonomy code 231H00000X

License

31090 Issued in OR

Practice address

1111 NE 99TH Ave Ste 101
Portland, OR 97220-9442

Phone

(503) 488-2626

Fax

(503) 488-2630

NPI assigned

Aug 28, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Specialty

Qualified Audiologist

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The Oregon Clinic, PCGroup PAC ID 2860390408, 353 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: cc_otoc_ent_east_front_desk_pool12223123@oc.providencedirect.org

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.

• The Oregon Clinic PC

  • Specialist
  • Portland, OR
  • NPI 1265417174
  Medicare reassignment Care Compare group NPD
• The Oregon Clinic, PC

  • Durable Medical Equipment & Medical Supplies
  • Portland, OR
  • NPI 1346105129
  NPD

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

{
    "created_epoch": "1693180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732579200000",
    "number": "1124803143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "541 NE 20TH AVE STE 225",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972322895",
            "telephone_number": "503-963-2801",
            "fax_number": "503-963-2825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 NE 99TH AVE STE 101",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972209442",
            "telephone_number": "503-488-2626",
            "fax_number": "503-488-2630"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "24076 SE Stark St Ste 230",
            "address_purpose": "LOCATION",
            "city": "Gresham",
            "state": "OR",
            "postal_code": "970303385",
            "country_code": "US",
            "telephone_number": "503-488-2600",
            "fax_number": "503-465-5468",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KING",
        "first_name": "PHILIP",
        "middle_name": "CRIGHTON",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "AUD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-08-28",
        "last_updated": "2024-11-26",
        "certification_date": "2024-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "OR",
            "license": "31090",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500827663",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2258846",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cc_otoc_ent_east_front_desk_pool12223123@oc.providencedirect.org",
            "affiliation": "Y",
            "affiliationName": "The Oregon Clinic PC",
            "address_1": "24076 SE Stark St Ste 230",
            "city": "Gresham",
            "state": "OR",
            "country_code": "US",
            "postal_code": "970303385",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Mitzy Elizabeth King, LCSW
• Natalie King, OTR/L
• Nicole Alicia King, CADC 1
• Noelle Denise King, N.D
• Peter King, QMHA
• Reilly King
• Sarah Kristin King, LCSW
• Seth Bartell King
• Shianling King, PH.D.
• Sonja Marie King

• Audiologist in Portland, OR
• Providers in Portland, OR by specialty
• Audiologist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.