Individual provider Active NPI

Janice A. King, PA-C

  • Physician Assistant
  • Wolfeboro, NH
National Provider Identifier
1255369443
Registry record updated Jan 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0711 Issued in NH
Practice address
240 S Main St
Suite H
Wolfeboro, NH 03894-4411
Phone
(603) 569-7500
Fax
(603) 515-2031
NPI assigned
Jun 28, 2006
Last updated
Jan 28, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2015

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MA051169 PA
Physician Assistant 363A00000X 0711 NH Primary
Physician Assistant 363A00000X OA000785 PA
Medical Physician Assistant 363AM0700X 25MP00100000 NJ

Addresses

Primary practice location

240 S Main St
Suite H
Wolfeboro, NH 03894-4411

Mailing address

240 S Main St
Wolfeboro, NH 03894-4411
Phone (603) 569-7500

Other identifiers 1

IdentifierTypeStateIssuer
3088665MedicaidNH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170707000271 MA Practitioner - Physician Assistant 5193793602 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0711NHMDDriving and Community Mobility Occupational Therapist
OA000785PAMDPhysician Assistant
25MP00100000NJMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Liberty Emergency Physicians LLC Past Accepting new patients
Emergency Care Services of Pennsylvania, P.C. Physician Assistant Past Accepting new patients
Portsmouth Emergency Physicians PC Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1151452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1422403200000",
    "number": "1255369443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 S MAIN ST",
            "city": "WOLFEBORO",
            "state": "NH",
            "postal_code": "038944411",
            "telephone_number": "603-569-7500",
            "fax_number": "603-515-2031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 S MAIN ST",
            "address_2": "SUITE H",
            "city": "WOLFEBORO",
            "state": "NH",
            "postal_code": "038944411",
            "telephone_number": "603-569-7500",
            "fax_number": "603-515-2031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KING",
        "first_name": "JANICE",
        "middle_name": "A.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-28",
        "last_updated": "2015-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA051169",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NH",
            "license": "0711",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "OA000785",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NJ",
            "license": "25MP00100000",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3088665",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wolfeboro, NH

Sources for this page

Verify at the official NPI Registry.