Alice King, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

MD184900 Issued in OR

Practice address

8645 SE Sunnybrook Blvd # 200
Clackamas, OR 97015-6841

Phone

(503) 659-1694

Fax

(503) 659-8984

NPI assigned

Apr 6, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Aug 12, 2021 through Aug 12, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: aking837493@oc.providencedirect.org

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.

• Oregon Pediatrics-Oregon City, PC

  • Pediatrics Physician
  • Oregon City, OR
  • NPI 1114558368
  NPD (past)
• Rupa K. Shah, MD, PC

  • Pediatrics Physician
  • Clackamas, OR
  • NPI 1275579906
  NPD (past)
• St Davids Healthcare Partnership LP LLP

  • General Acute Care Hospital
  • Austin, TX
  • NPI 1629021845
  NPD (past)

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

{
    "created_epoch": "1144281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1194788752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8645 SE SUNNYBROOK BLVD # 200",
            "city": "CLACKAMAS",
            "state": "OR",
            "postal_code": "970156841",
            "telephone_number": "503-659-1694",
            "fax_number": "503-659-8984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8645 SE SUNNYBROOK BLVD # 200",
            "city": "CLACKAMAS",
            "state": "OR",
            "postal_code": "970156841",
            "telephone_number": "503-659-1694",
            "fax_number": "503-659-8984"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3001 E President George Bush Hwy",
            "address_2": "Suite 250",
            "address_purpose": "LOCATION",
            "city": "Richardson",
            "state": "TX",
            "postal_code": "750823542",
            "country_code": "US",
            "telephone_number": "214-343-6663 x227",
            "fax_number": "214-343-2814",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KING",
        "first_name": "ALICE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-06",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "L8768",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OR",
            "license": "MD184900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Morris Maroo Kim, MD
• Alexa Dorothy Kimball, CRNA
• Melissa Rae Kinder, MD
• Kyle James Kinderknecht, M.D.
• King Road Family Dentistry
• Daniel F King, M.D.
• Jerry Everett King, M.D.
• Lia Elizabeth King, RRT
• Melinda Kingery
• Suzan Diane Kingma, LCSW

• Pediatrics Physician in Clackamas, OR
• Providers in Clackamas, OR by specialty
• Pediatrics Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.