Kellie Ruth King, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

1017997 Issued in TX

Practice address

5937 Donnelly Ave
Fort Worth, TX 76107-5811

Phone

(682) 212-9140

NPI assigned

Sep 24, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TX, UT2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Primary Health Physicians PLLCGroup PAC ID 7810237740, 240 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://epicproxy.et1057.epichosted.com/FHIRProxy/api/FHIR/R4/

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.

• Primary Health Physicians, PLLC

  • Urgent Care Clinic/Center
  • Denton, TX
  • NPI 1770048704
  Medicare reassignment Care Compare group NPD
• Texas Health Urgent Care

  • Urgent Care Clinic/Center
  • Arlington, TX
  • NPI 1952915365

  Family

  Medicare reassignment NPD
• Molina Healthcare of Utah Inc

  • Family Nurse Practitioner
  • Midvale, UT
  • NPI 1619486396
  Medicare reassignment NPD
• Signify Health Medical Associates, PLLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1750845863
  Medicare reassignment
• Molina Care Connections, LLC.

  • Nurse Practitioner
  • Long Beach, CA
  • NPI 1407243223

  TX

  Medicare reassignment
• Precision Primary, LLC

  • Primary Care Nurse Practitioner
  • Grand Prairie, TX
  • NPI 1134040108
  NPD (past) Authorized official
• Texas Health Urgent Care

  • Urgent Care Clinic/Center
  • Dallas, TX
  • NPI 1104431527
  NPD
• Texas Health Urgent Care

  • Urgent Care Clinic/Center
  • Allen, TX
  • NPI 1629724315
  NPD
• Texas Health Urgent Care

  • Urgent Care Clinic/Center
  • McKinney, TX
  • NPI 1972118388
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1600905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679961600000",
    "number": "1316554264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5605 N MACARTHUR BLVD STE 400",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750382693",
            "telephone_number": "469-400-4784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5937 DONNELLY AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761075811",
            "telephone_number": "682-212-9140"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7043 Miramar",
            "address_purpose": "LOCATION",
            "city": "Grand Prairie",
            "state": "TX",
            "postal_code": "750545563",
            "country_code": "US",
            "telephone_number": "561-577-1877",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KING",
        "first_name": "KELLIE",
        "middle_name": "RUTH",
        "name_prefix": "Dr.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-24",
        "last_updated": "2023-03-28",
        "certification_date": "2023-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11009343",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1017997",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dolores K King, MD
• Jasmine Coleman King
• Jason King
• Jennifer King
• Kathryn Cummins King, M.D.
• Kellye King, OT
• Kenneth Brian King, OD
• Kristi Renea King, M.D.
• Latorian King, OD
• Megan King, APRN, FNP-C

• Family Nurse Practitioner in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2023; 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.
• 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.