Individual provider Active NPI

Nicole Marie King, MD

  • Pediatrics Physician
  • Tucson, AZ
National Provider Identifier
1295296465
Registry record updated Jul 15, 2022
On this page

Key facts

NPPES NPI Registry
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
Last updated
Jul 15, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Pediatrics Physician 208000000X 66445 AZ Primary

Addresses

Primary practice location

1501 N Campbell Ave
Tucson, AZ 85724-1601

Mailing address

3523 N Stewart Ave
Tucson, AZ 85716-1241
Phone (484) 560-0656

Other practice location 1

725 Welch Rd
Palo Alto, CA 94304-1601
Phone (650) 497-8000

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20220706000786 AZ Practitioner - Pediatric Medicine 5799165973 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Banner-University Medical Group Family Medicine CurrentSince Jul 11, 2022 Accepting new patients
Banner-University Medical Group CurrentSince Jul 11, 2022 Accepting new patients
Banner - University Medical Center Tucson Campus LLC Past Accepting new patients

Locations

1501 N Campbell Ave
Tucson, AZ 85724
Phone (520) 626-7747

1625 N Campbell Ave
Tucson, AZ 85719

2167 W Orange Grove Rd
Tucson, AZ 85741
Phone (520) 544-7650

265 W Ina Rd
Tucson, AZ 85704
Phone (520) 694-8000

2800 E Ajo Way
Tucson, AZ 85713
Phone (520) 294-4471

2945 W Ina Rd
Ste 121
Tucson, AZ 85741
Phone (520) 694-7601

535 N Wilmot Rd
Ste 101
Tucson, AZ 85711
Phone (520) 694-9988

8290 S Houghton Rd
Ste 150
Tucson, AZ 85747
Phone (520) 694-1045

Organizations & group practices 3

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": "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": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.