Organization Active NPI

Syllette King MD PA

  • Obstetrics & Gynecology Physician
  • Orlando, FL
National Provider Identifier
1265545933
Registry record updated Feb 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
ME69026 Issued in FL
Legal business name
SYLLETTE KING MD PA
Practice address
506 S Chickasaw TRL
Suite 100
Orlando, FL 32825-7833
Phone
(407) 828-8775
Fax
(407) 282-0886
NPI assigned
Aug 16, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2014

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

Authorized official

Name
Syllette King, MDNPI 1629007224
Title
Qwner
Phone
(407) 282-8776

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207V00000X ME69026 FL Primary

Addresses

Primary practice location

506 S Chickasaw TRL
Suite 100
Orlando, FL 32825-7833

Mailing address

506 S Chickasaw TRL
Suite 100
Orlando, FL 32825-7833
Phone (407) 828-8775

Other identifiers 1

IdentifierTypeStateIssuer
252007900MedicaidFL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20061023000066 FL Part B Supplier - Clinic/Group Practice 3274530993 Receives reassigned benefits from 1 practitioner
Practice locations: Orlando, FL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D0928601Syllette King MD PA506 S Chickasaw TRL Ste 100, Orlando, FL 32825Certificate of waiverDec 9, 2027

National Provider Directory

National Provider Directory

Locations

506 S Chickasaw Trl
Ste 100
Orlando, FL 32825
Phone (407) 282-8775

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/13297/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 1

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": "1155686400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1392076800000",
    "number": "1265545933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "506 S CHICKASAW TRL",
            "address_2": "SUITE 100",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328257833",
            "telephone_number": "407-828-8775",
            "fax_number": "407-282-0886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "506 S CHICKASAW TRL",
            "address_2": "SUITE 100",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328257833",
            "telephone_number": "407-828-8775",
            "fax_number": "407-282-0886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SYLLETTE KING MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-16",
        "last_updated": "2014-02-11",
        "status": "A",
        "authorized_official_last_name": "KING",
        "authorized_official_first_name": "SYLLETTE",
        "authorized_official_title_or_position": "QWNER",
        "authorized_official_telephone_number": "407-282-8776",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "FL",
            "license": "ME69026",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "252007900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.