Kingskids Physicians, LLC

Primary specialty

Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X

License

D0064420 Issued in MD

Legal business name

KINGSKIDS PHYSICIANS, LLC

Doing business as

KingsKids Clinic

Practice address

13932 Baltimore Ave
11
Laurel, MD 20707-5000

Phone

(443) 653-1229

Fax

(410) 315-7868

NPI assigned

Aug 12, 2015

Organization subpart

Yes

Parent organization

KINGSKIDS PHYSICIANS, LLCAs reported in NPPES

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

Authorized official

Name

Mr. Sunday Chuks Okparaocha

Title

Office Manager

Phone

(443) 653-1229

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• KingsKids Clinic Doing business as

Part of

Kingskids Physicians LLC

Locations

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

{
    "created_epoch": "1439337600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1439337600000",
    "number": "1144696220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13932 BALTIMORE AVE",
            "address_2": "11",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207075000",
            "telephone_number": "443-653-1229",
            "fax_number": "410-315-7868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13932 BALTIMORE AVE",
            "address_2": "11",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207075000",
            "telephone_number": "443-653-1229",
            "fax_number": "410-315-7868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KINGSKIDS PHYSICIANS, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "KINGSKIDS PHYSICIANS, LLC",
        "enumeration_date": "2015-08-12",
        "last_updated": "2015-08-12",
        "status": "A",
        "authorized_official_last_name": "OKPARAOCHA",
        "authorized_official_first_name": "SUNDAY",
        "authorized_official_middle_name": "CHUKS",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "443-653-1229",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "MD",
            "license": "D0064420",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "335147500",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "KingsKids Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kinetic Balance Collective
• King Health Systems, Inc
• King Health Systems, Inc.
• Aisha King, PH.D.
• Deborah King
• David S Kirabo
• Beverly L Kirby, BCBA
• Sarah Kirkpatrick
• Samantha B Kisakye
• Kevin Jonathan Kisicki, D.D.S.

• Pediatric Adolescent Medicine Physician in Laurel, MD
• Providers in Laurel, MD by specialty
• Pediatric Adolescent Medicine Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.