Nicole Marie King, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

66445 Issued in AZ

Practice address

1501 N Campbell Ave
Tucson, AZ 85724-1601

Phone

(520) 626-0923

Fax

(520) 626-2808

NPI assigned

Mar 28, 2019

Sex

Female

Sole proprietor

No

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.

• Banner-University Medical Group

  • Multi-Specialty Clinic/Center
  • Phoenix, AZ
  • NPI 1508809427

  AZ, Family Medicine

  Medicare reassignment NPD
• Banner-University Medical Group

  • Durable Medical Equipment & Medical Supplies
  • Tucson, AZ
  • NPI 1922820935
  NPD
• Banner - University Medical Center Tucson Campus LLC

  • General Acute Care Hospital
  • Tucson, AZ
  • NPI 1265820179
  NPD (past)

Medicare fee-for-service enrollment

Enrolled in AZ

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 15, 2022.

{
    "created_epoch": "1553731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657843200000",
    "number": "1295296465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3523 N STEWART AVE",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857161241",
            "telephone_number": "484-560-0656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 N CAMPBELL AVE",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857241601",
            "telephone_number": "520-626-0923",
            "fax_number": "520-626-2808"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "725 Welch Rd",
            "address_purpose": "LOCATION",
            "city": "Palo Alto",
            "state": "CA",
            "postal_code": "943041601",
            "country_code": "US",
            "telephone_number": "650-497-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KING",
        "first_name": "NICOLE",
        "middle_name": "MARIE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-28",
        "last_updated": "2022-07-15",
        "certification_date": "2022-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AZ",
            "license": "66445",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Danielle King, SLP
• John Martin King
• Kay D King
• Lauren Elizabeth King, PA
• N. Judge King III, MD
• Skye King, M.D.
• Summer Nikole King
• Kingdom Advancements
• Isabel Marie Kingman, RBT
• Kings and Queens Royalty Assisted Living LLC

• All providers in Tucson, AZ
• Pediatrics Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.