Individual provider Active NPI

Robert Randolph King, M.D.

  • Orthopaedic Surgery Physician
  • Lubbock, TX
National Provider Identifier
1336242593
Registry record updated Aug 25, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
E4454 Issued in TX
Practice address
4110 22ND PL
Lubbock, TX 79410-1122
Phone
(806) 792-4329
Fax
(806) 792-9466
NPI assigned
Sep 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X E4454 TX Primary

Addresses

Primary practice location

4110 22ND PL
Lubbock, TX 79410-1122

Mailing address

4110 22ND PL
Lubbock, TX 79410-1122
Phone (806) 792-4329

Other identifiers 2

IdentifierTypeStateIssuer
043965501MedicaidTX
8G7061OtherTXBLUE CROSS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20070328000318 TX Practitioner - Orthopedic Surgery 7810934668 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
CSK Medical Partners CurrentSince Jul 1, 2008 Accepting new patients
CSK Medical Partners Orthopaedic Surgery CurrentSince Jul 1, 2008 Accepting new patients

Locations

4110 22nd Pl
Lubbock, TX 79410
Phone (806) 792-4329

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1157500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1251158400000",
    "number": "1336242593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4110 22ND PL",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794101122",
            "telephone_number": "806-792-4329",
            "fax_number": "806-792-9466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4110 22ND PL",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794101122",
            "telephone_number": "806-792-4329",
            "fax_number": "806-792-9466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KING",
        "first_name": "ROBERT",
        "middle_name": "RANDOLPH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-06",
        "last_updated": "2009-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "TX",
            "license": "E4454",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "043965501",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "8G7061",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lubbock, TX

Sources for this page

Verify at the official NPI Registry.