Individual provider Active NPI

Jonathan M King, DPM

  • Foot & Ankle Surgery Podiatrist
  • Chesterfield, MI
National Provider Identifier
1174779441
Registry record updated May 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
5901002282 Issued in MI
Practice address
32743 23 Mile Rd
Ste 210
Chesterfield, MI 48047-1985
Phone
(586) 725-3444
Fax
(586) 725-0984
NPI assigned
Aug 18, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 5901002282 MI Primary

Addresses

Primary practice location

32743 23 Mile Rd
Ste 210
Chesterfield, MI 48047-1985

Mailing address

9400 S Cicero Ave Ste 100
Oak Lawn, IL 60453-2536
Phone (708) 424-3201

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130306000556 MI Practitioner - Podiatry 4981874252 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
College of Podiatric Med and Surgery, Des Moines University, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Great Lakes Foot and Ankle Institute PLLCGroup PAC ID 1557323904, 15 clinicians

Practice addresses (Care Compare)

1135 W University Dr
Suite 305
Rochester, MI 48307-1892
Phone (586) 725-3444

13350 24 Mile Rd
Suite 600
Shelby TWP, MI 48315-1827
Phone (586) 725-3444

32743 23 Mile Rd
Chesterfield, MI 48047-2082
Phone (586) 725-3444

4190 24TH Ave
Suite 102
Fort Gratiot, MI 48059-3883
Phone (586) 725-3444

43900 Garfield Rd
Suite 140
Clinton TWP, MI 48038-1137
Phone (586) 725-3444

Hospital & facility affiliations

  • Henry Ford Health St John Hospital Hospital, Detroit, MI, CCN 230165

Merit-based Incentive Payment System (MIPS)

Final score
64.84 of 100Reported as individual
Quality
27.07
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue49
Removal of skin lesions1-10
Removal of nail tissue486
Removal or shaving of skin growth66

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5901002282MIMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Great Lakes Foot & Ankle Institute PLLC Foot & Ankle Surgery CurrentSince Feb 4, 2013 Accepting new patients
Great Lakes Foot & Ankle Institute PLLC Current Accepting new patients
Great Lakes Foot & Ankle Institute PLLC Foot & Ankle Surgery CurrentSince Feb 4, 2013 Accepting new patients
Peyman a. Elison DPM PC Foot & Ankle Surgery Past Accepting new patients
General Hosp Medical Assoc, P.C. Past Accepting new patients
Fixingfeet, PLLC Foot & Ankle Surgery PastSince Aug 15, 2011 Accepting new patients

Locations

9400 S Cicero Ave
Ste 100
Oak Lawn, IL 60453
Phone (816) 673-3522

4650 Southwest Hwy
Oak Lawn, IL 60453
Phone (708) 424-3202

32743 23 Mile Rd
Ste 110
Chesterfield, MI 48047
Phone (586) 404-9703

32743 23 Mile Rd
Ste 210
Chesterfield, MI 48047

43900 Garfield Rd
Ste 140
Clinton Twp, MI 48038

4190 24th Ave
Ste 102
Fort Gratiot, MI 48059

36622 Green St
New Baltimore, MI 48047
Phone (313) 725-3444

1135 W University Dr
Ste 305
Rochester Hls, MI 48307
Phone (248) 651-0162

13350 24 Mile Rd
Ste 600
Shelby Township, MI 48315

Interoperability endpoints

  • Direct secure messaging: jking252676@direct.hfhs.org

Organizations & group practices 6

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.

Hospital & facility affiliations 1

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": "1219017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747526400000",
    "number": "1174779441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9400 S CICERO AVE STE 100",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604532536",
            "telephone_number": "708-424-3201",
            "fax_number": "708-424-5001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32743 23 MILE RD",
            "address_2": "STE 210",
            "city": "CHESTERFIELD",
            "state": "MI",
            "postal_code": "480471985",
            "telephone_number": "586-725-3444",
            "fax_number": "586-725-0984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KING",
        "first_name": "JONATHAN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-08-18",
        "last_updated": "2025-05-18",
        "certification_date": "2025-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "MI",
            "license": "5901002282",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesterfield, MI

Sources for this page

Verify at the official NPI Registry.