Active NPI
Brock K. King, M.D.
- Surgery Physician
- Conway, AR
National Provider Identifier
1154323921
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- E2394
- Practice address
- 525 Western Ave
Suite 203
Conway, AR 72034-4967 - Phone
- (501) 327-4828
- Fax
- (501) 327-6899
- NPI assigned
- Aug 11, 2005
- 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 |
|---|---|---|---|---|
| Surgery Physician | 208600000X | E2394 | AR | Primary |
Addresses
Primary practice location
525 Western Ave
Suite 203
Conway, AR 72034-4967
Mailing address
525 Western Ave
Suite 203
Conway, AR 72034-4967
Phone (501) 327-4828
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 020048444 | Other | AR | MEDICARE RAILROAD |
| 1720143 | Other | AR | UNITED HEALTH CARE |
| 18487000000 | Other | AR | QUALCHOICE |
| 140135001 | Medicaid | AR |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AR
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- General Surgery
- Education
- University of Arkansas College of Medicine, 1994
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
525 Western Ave
Suite 203
Conway, AR 72034-4980
Phone (501) 327-4828
Hospital & facility affiliations
- Conway Regional Medical Center, Inc
- Ozark Health
- Dardanelle Regional Medical Center
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Colonoscopy | 1-10 |
| Hernia repair - groin (open) | 1-10 |
| Hernia repair (minimally invasive) | 1-10 |
| Mastectomy | 1-10 |
| Upper gastrointestinal (GI) endoscopy for acid reflux | 1-10 |
| Removal of tissue | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Conway Regional Medical Center Inc | Current | Accepting new patients | |
| Conway Regional Medical Center Inc | Surgery | Current | Accepting new patients |
| Conway Regional Medical Center Inc | Past | Accepting new patients |
Locations
2526 Highway 65 S
Ste 203
Clinton, AR 72031
Phone (501) 745-4914
525 Western Ave
Ste 203
Conway, AR 72034
Phone (501) 327-4828
200 N 3rd St
Ste 3
Dardanelle, AR 72834
Phone (479) 229-4677
Interoperability endpoints
- king.brock.005.0040049@sac.meditab.direct-ci.com
- king.brock.008.0040049@sac.meditab.direct-ci.com
Organizations & group practices 4
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.
-
- Surgery Physician
- Conway, AR
- NPI 1932663879
-
- Family Medicine Physician
- Dardanelle, AR
- NPI 1730737131
-
- Family Medicine Physician
- Conway, AR
- NPI 1043183544
-
- General Acute Care Hospital
- Conway, AR
- NPI 1497770424
Hospital & facility affiliations 8
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Conway, AR
- NPI 1497770424
-
- Family Medicine Physician
- Russellville, AR
- NPI 1245729359
Hospital
-
- Rural Health Clinic/Center
- Mayflower, AR
- NPI 1851389605
Hospital
-
- Critical Access Hospital
- Dardanelle, AR
- NPI 1184629594
-
- Critical Access Hospital
- Clinton, AR
- NPI 1992760342
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1123718400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1258502400000",
"number": "1154323921",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "525 WESTERN AVE",
"address_2": "SUITE 203",
"city": "CONWAY",
"state": "AR",
"postal_code": "720344967",
"telephone_number": "501-327-4828",
"fax_number": "501-327-6899"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "525 WESTERN AVE",
"address_2": "SUITE 203",
"city": "CONWAY",
"state": "AR",
"postal_code": "720344967",
"telephone_number": "501-327-4828",
"fax_number": "501-327-6899"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KING",
"first_name": "BROCK",
"middle_name": "K.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-08-11",
"last_updated": "2009-11-18",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "AR",
"license": "E2394",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RAILROAD",
"identifier": "020048444",
"state": "AR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTH CARE",
"identifier": "1720143",
"state": "AR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "QUALCHOICE",
"identifier": "18487000000",
"state": "AR"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "140135001",
"state": "AR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Conway, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.