NPIMap

Organization Active NPI

King Spinal & Sports Rehabilitation, LTD.

  • Physical Therapist
  • Granite City, IL
National Provider Identifier
1427157593
Registry record updated Apr 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070009347 Issued in IL
Legal business name
KING SPINAL & SPORTS REHABILITATION, LTD.
Practice address
1525 Johnson Rd
Granite City, IL 62040-3831
Phone
(618) 452-1986
Fax
(618) 452-6814
NPI assigned
Sep 22, 2006
Last updated
Apr 2, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2026

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

Authorized official

Name
Dr. Charles E King Jr., D.C.NPI 1285733360
Title
President
Phone
(618) 452-1986

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038005195 IL
Physical Therapist 225100000X 070009347 IL Primary

Addresses

Primary practice location

1525 Johnson Rd
Granite City, IL 62040-3831

Mailing address

PO Box 943
Granite City, IL 62040-0943
Phone (618) 452-1986

Other identifiers 2

IdentifierTypeStateIssuer
038005195MedicaidIL
06032044OtherBC/BS OF ILLINOIS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060419000599 IL Part B Supplier - Clinic/Group Practice 2466461439 Receives reassigned benefits from 4 practitioners
Practice locations: Granite City, IL

National Provider Directory

National Provider Directory

Locations

1525 Johnson Rd
Granite City, IL 62040
Phone (618) 452-1986

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1775088000000",
    "number": "1427157593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 943",
            "city": "GRANITE CITY",
            "state": "IL",
            "postal_code": "620400943",
            "telephone_number": "618-452-1986",
            "fax_number": "618-452-6814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1525 JOHNSON RD",
            "city": "GRANITE CITY",
            "state": "IL",
            "postal_code": "620403831",
            "telephone_number": "618-452-1986",
            "fax_number": "618-452-6814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KING SPINAL & SPORTS REHABILITATION, LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-22",
        "last_updated": "2026-04-02",
        "certification_date": "2026-04-02",
        "status": "A",
        "authorized_official_last_name": "KING",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "618-452-1986",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038005195",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070009347",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "038005195",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS OF ILLINOIS",
            "identifier": "06032044",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Granite City, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.