NPIMap

Individual provider Active NPI

Jeffrey R King, DPM

  • Podiatrist
  • Windsor, VT
National Provider Identifier
1306065115
Registry record updated Mar 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
056-0000171 Issued in VT
Practice address
289 County Rd
Windsor, VT 05089-9000
Phone
(802) 674-7300
Fax
(802) 674-7314
NPI assigned
Apr 24, 2007
Last updated
Mar 9, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 056-0000171 VT Primary

Addresses

Primary practice location

289 County Rd
Windsor, VT 05089-9000

Mailing address

289 County Rd
Windsor, VT 05089-9000
Phone (802) 674-7300

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jeffreyrking@mahhc.cernerdirect.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VT
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060425000103 VT Practitioner - Podiatry 3476563206 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Windsor Hospital CorporationGroup PAC ID 2860387214, shared by 6 NPIs, 56 clinicians

Practice addresses (Care Compare)

289 County Rd
Windsor, VT 05089-9000
Phone (802) 674-7300

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of skin lesions1-10
Removal of nail tissue26
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
056-0000171VTMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Windsor Hospital Corporation CurrentSince Aug 30, 2010 Accepting new patients
Windsor Hospital Corporation CurrentSince Aug 30, 2010 Accepting new patients
Windsor Hospital Corporation Current Accepting new patients
Associates in Podiatry PC Podiatrist PastSince Jun 1, 1992 Accepting new patients
Long Trail Podiatry PLLC Podiatrist PastSince Jan 1, 2007 Accepting new patients

Locations

2456 Christian St
Ste L2
White River Junction, VT 05001
Phone (802) 359-4335

289 County Rd
Windsor, VT 05089
Phone (802) 674-7220

Interoperability endpoints

  • Direct secure messaging: jeffreyrking@mahhc.cernerdirect.com
  • Direct secure messaging: jking622865@direct.dartmouth-hitchcock.org

Ownership & related parties

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Mt Ascutney Hospital and Health CenterWindsor, VT, CCN 471302 Hospital Corporate Director Jan 1, 2024
Mt Ascutney Hospital and Health CenterWindsor, VT, CCN 47Z302 Hospital Corporate Director Jan 1, 2024
Mt Ascutney Hospital and Health CenterWindsor, VT, CCN 47R302 Hospital Corporate Director Jan 1, 2024

Owned or controlled facilities with NPI records 5

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 5

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.

Hospital & facility affiliations 4

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": "1177372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615248000000",
    "number": "1306065115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "289 COUNTY RD",
            "city": "WINDSOR",
            "state": "VT",
            "postal_code": "050899000",
            "telephone_number": "802-674-7300",
            "fax_number": "802-674-7314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "289 COUNTY RD",
            "city": "WINDSOR",
            "state": "VT",
            "postal_code": "050899000",
            "telephone_number": "802-674-7300",
            "fax_number": "802-674-7314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KING",
        "first_name": "JEFFREY",
        "middle_name": "R",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-24",
        "last_updated": "2021-03-09",
        "certification_date": "2021-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "VT",
            "license": "056-0000171",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jeffreyrking@mahhc.cernerdirect.com",
            "affiliation": "N",
            "address_1": "289 County Rd",
            "city": "Windsor",
            "state": "VT",
            "country_code": "US",
            "postal_code": "050899000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Windsor, VT

Sources for this page

Verify at the official NPI Registry.