Individual provider Active NPI

Alicia Ann King, D.O., MPH

  • Neuromusculoskeletal Medicine & OMM Physician
  • Sikeston, MO
National Provider Identifier
1255884359
Registry record updated Sep 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neuromusculoskeletal Medicine & OMM PhysicianTaxonomy code 204D00000X
License
2019000490 Issued in MO
Practice address
102 Hospitality Dr
Sikeston, MO 63801-9382
Phone
(573) 471-0200
NPI assigned
Jul 26, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 17, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neuromusculoskeletal Medicine & OMM Physician 204D00000X 2019000490 MO Primary
Family Medicine Physician 207Q00000X 2016021991 MO

Addresses

Primary practice location

102 Hospitality Dr
Sikeston, MO 63801-9382

Mailing address

1008 N Main St
Sikeston, MO 63801-5044
Phone (573) 471-0200

Other identifiers 1

IdentifierTypeStateIssuer
200071642MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190725003547 MO Practitioner - Family Practice 9335475573 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Missouri Delta Medical CenterGroup PAC ID 1355252891, 134 clinicians

Practice addresses (Care Compare)

1008 N Main St
Sikeston, MO 63801-5044
Phone (573) 471-1600

1015 N Main St
Sikeston, MO 63801-5043
Phone (573) 472-7777

1017 N Main St
Sikeston, MO 63801-5043
Phone (573) 472-6030

1019 N Main St
Sikeston, MO 63801-5043
Phone (573) 472-7702

1106 N Main St
Missouri Delta Urology
Sikeston, MO 63801-5046
Phone (573) 471-8656

1118 N Main St
Sikeston, MO 63801-5046
Phone (573) 471-4417

1126 N Main St
Sikeston, MO 63801-5046
Phone (573) 471-4312

125 Plaza Dr
Sikeston, MO 63801-5136
Phone (573) 472-7124

135 Plaza Dr
Sikeston, MO 63801-5148

201 Plaza Dr
Sikeston, MO 63801-5110

201 Plaza Dr
Suite C
Sikeston, MO 63801-5105
Phone (573) 481-1072

203 Plaza Dr
Sikeston, MO 63801-5105
Phone (573) 475-6488

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
2019000490MOMDNeuromusculoskeletal Medicine & OMM Physician
2016021991MOMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Missouri Delta Medical Center Family Medicine CurrentSince Jun 29, 2020 Accepting new patients
Missouri Delta Medical Center CurrentSince Jun 29, 2020 Accepting new patients

Locations

1008 N Main St
Sikeston, MO 63801
Phone (573) 471-1600

Organizations & group practices 2

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 3

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": "1469491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631836800000",
    "number": "1255884359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1008 N MAIN ST",
            "city": "SIKESTON",
            "state": "MO",
            "postal_code": "638015044",
            "telephone_number": "573-471-0200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 HOSPITALITY DR",
            "city": "SIKESTON",
            "state": "MO",
            "postal_code": "638019382",
            "telephone_number": "573-471-0200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KING",
        "first_name": "ALICIA",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "D.O., MPH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-07-26",
        "last_updated": "2021-09-17",
        "certification_date": "2021-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204D00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine & OMM",
            "state": "MO",
            "license": "2019000490",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2016021991",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200071642",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sikeston, MO

Sources for this page

Verify at the official NPI Registry.