NPIMap

Individual provider Active NPI

Kevin P King, M.D.

  • Family Medicine Physician
  • Kirkwood, MO
National Provider Identifier
1174733620
Registry record updated Feb 18, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2008005698 Issued in MO
Practice address
816 S Kirkwood Rd Ste 210
Kirkwood, MO 63122-6056
Phone
(314) 822-6830
Fax
(314) 822-6859
NPI assigned
May 23, 2007
Last updated
Feb 18, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 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 2008005698 MO Primary

Addresses

Primary practice location

816 S Kirkwood Rd Ste 210
Kirkwood, MO 63122-6056

Mailing address

816 S Kirkwood Rd Ste 210
Kirkwood, MO 63122-6056
Phone (314) 822-6830

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090914000183 MO Practitioner - Family Practice 5294881421 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Saint Louis University School of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mercy Clinic East CommunitiesGroup PAC ID 7214827922, 573 clinicians

Practice addresses (Care Compare)

10700 Manchester Rd
Suite D
Kirkwood, MO 63122-1307
Phone (314) 822-6830

12680 Olive Blvd
Saint Louis, MO 63141-6322

621 S New Ballas Rd
Suite 4017B
Saint Louis, MO 63141-8269
Phone (314) 872-9192

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic East Communities Family Medicine CurrentSince Sep 1, 2009 Accepting new patients
Mercy Hospitals East Communities CurrentSince Mar 14, 2012 Accepting new patients

Locations

615 S New Ballas Rd
Saint Louis, MO 63141
Phone (314) 251-4687

621 S New Ballas Rd
Ste 189A
Saint Louis, MO 63141
Phone (314) 251-6335

621 S New Ballas Rd
Ste 4017B
Saint Louis, MO 63141
Phone (314) 872-9192

816 S Kirkwood Rd
Ste 210
Saint Louis, MO 63122
Phone (314) 645-4500

Interoperability endpoints

  • Direct secure messaging: kking372@directc.mercy.net

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1266451200000",
    "number": "1174733620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "816 S KIRKWOOD RD STE 210",
            "city": "KIRKWOOD",
            "state": "MO",
            "postal_code": "631226056",
            "telephone_number": "314-822-6830",
            "fax_number": "314-822-6859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "816 S KIRKWOOD RD STE 210",
            "city": "KIRKWOOD",
            "state": "MO",
            "postal_code": "631226056",
            "telephone_number": "314-822-6830",
            "fax_number": "314-822-6859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KING",
        "first_name": "KEVIN",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-23",
        "last_updated": "2010-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2008005698",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kirkwood, MO

Sources for this page

Verify at the official NPI Registry.