NPIMap

Organization Active NPI

King'S Daughters Medical Specialties, Inc.

  • Psychiatry Physician
  • Portsmouth, OH
National Provider Identifier
1184468639
Registry record updated Jun 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
KING'S DAUGHTERS MEDICAL SPECIALTIES, INC.
Practice address
1729 Kinneys LN Ste 101
Portsmouth, OH 45662-3166
Phone
(740) 529-2440
Fax
(740) 529-2442
NPI assigned
Jun 20, 2024
Organization subpart
Yes
Parent organization
KING'S DAUGHTERS MEDICAL SPECIALTIES, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 20, 2024

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

Authorized official

Name
Sara Marks
Title
President
Phone
(606) 408-4000

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X Primary
Addiction Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0802X

Addresses

Primary practice location

1729 Kinneys LN Ste 101
Portsmouth, OH 45662-3166

Mailing address

PO Box 2379
Ashland, KY 41105-2379

Other names 1

  • Kings Daughters Medical Specialties - Behavioral Health Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100114000813 OH Part B Supplier - Clinic/Group Practice 6103968029 Receives reassigned benefits from 181 practitioners
24 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Wheelersburg, OH; Waverly, OH; South Point, OH; Portsmouth, OH; Lucasville, OH; Jackson, OH; Ironton, OH; Franklin Furance, OH

Other NPIs on the same Medicare enrollment 24

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 24

National Provider Directory

National Provider Directory
Tax ID family
Kings Daughters Medical Specialties Interventional Spine23 organizations share this tax ID, including this one
Part of
Kings Daughters Medical Specialties Interventional Spine

Other organizations with this tax ID 22

Organizations that report the same tax identification number in the National Provider Directory.

View all 22

Locations

1061 Kenwood Dr
Russell, KY 41169
Phone (606) 326-1675

1729 Kinneys Ln
Ste 101
Portsmouth, OH 45662
Phone (740) 529-2440

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1718841600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718841600000",
    "number": "1184468639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2379",
            "city": "ASHLAND",
            "state": "KY",
            "postal_code": "411052379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1729 KINNEYS LN STE 101",
            "city": "PORTSMOUTH",
            "state": "OH",
            "postal_code": "456623166",
            "telephone_number": "740-529-2440",
            "fax_number": "740-529-2442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KING'S DAUGHTERS MEDICAL SPECIALTIES, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "KING'S DAUGHTERS MEDICAL SPECIALTIES, INC.",
        "enumeration_date": "2024-06-20",
        "last_updated": "2024-06-20",
        "certification_date": "2024-06-20",
        "status": "A",
        "authorized_official_last_name": "MARKS",
        "authorized_official_first_name": "SARA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "606-408-4000"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2084P0802X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Addiction Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kings Daughters Medical Specialties - Behavioral Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Portsmouth, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.