Active NPI
Darvis Elam King, DPT, MS ATC
- Physical Therapist
- Hopedale, IL
National Provider Identifier
1174887962
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 070013320
- Practice address
- 107 Tremont St
Hopedale, IL 61747-7525 - Phone
- (309) 449-4501
- NPI assigned
- Jun 27, 2012
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 070013320 | IL | Primary |
Addresses
Primary practice location
107 Tremont St
Hopedale, IL 61747-7525
Mailing address
107 Tremont St
Hopedale, IL 61747-7525
Phone (309) 449-4501
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 070013320 | IL | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1340755200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1340755200000",
"number": "1174887962",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "107 TREMONT ST",
"city": "HOPEDALE",
"state": "IL",
"postal_code": "617477525",
"telephone_number": "309-449-4501"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "107 TREMONT ST",
"city": "HOPEDALE",
"state": "IL",
"postal_code": "617477525",
"telephone_number": "309-449-4501"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KING",
"first_name": "DARVIS",
"middle_name": "ELAM",
"name_prefix": "Mr.",
"credential": "DPT, MS ATC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-06-27",
"last_updated": "2012-06-27",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IL",
"license": "070013320",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hopedale, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.