NPIMap

Individual provider Active NPI

Randall W King, MD

  • Emergency Medicine Physician
  • Toledo, OH
National Provider Identifier
1447213673
Registry record updated Jun 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
35047670 Issued in OH
Practice address
2213 Cherry St
Toledo, OH 43608-2603
Phone
(419) 251-3232
NPI assigned
Apr 10, 2006
Last updated
Jun 24, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 35047670 OH Primary

Addresses

Primary practice location

2213 Cherry St
Toledo, OH 43608-2603

Mailing address

4750 Hempstead Station Dr
Kettering, OH 45429-5164
Phone (800) 875-0136

Other identifiers 7

IdentifierTypeStateIssuer
727073OtherOHBUCKEYE COMMUNITY NUMBER
104758929MedicaidOH
0540847MedicaidOH
104734103MedicaidOH
000000360656OtherOHBC/BS INDIVIDUAL NUMBER
000000371637OtherOHBC/BS # ST VOBS
P00209987OtherOHRAILROAD MEDICARE NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20040102000128 OH Practitioner - Emergency Medicine 6709781628 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35047670OHMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Emergency Care Services, Inc. Emergency Medicine CurrentSince Apr 15, 2015 Accepting new patients
Emergency Department Consultants, Inc Emergency Medicine CurrentSince Oct 13, 2014 Accepting new patients
New Century Medical Observation Services of Lucas County, Inc Emergency Medicine Past Accepting new patients
Riverwood Emergency Services Inc. Emergency Medicine Past Accepting new patients

Locations

1404 E 2nd St
Defiance, OH 43512
Phone (567) 368-1008

2600 Navarre Ave
Oregon, OH 43616
Phone (419) 696-7200

2213 Cherry St
Toledo, OH 43608
Phone (419) 251-4283

Ownership & related parties

All facility ownership & control disclosures 8

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

FacilityTypeRoleSince
Mercy Health - Defiance HospitalDefiance, OH, CCN 360270 Hospital Corporate Director Jan 1, 2022
Mercy Health St. Vincent Medical CenterToledo, OH, CCN 360112 Hospital Corporate Director Jan 1, 2022
Mercy Health - Tiffin HospitalTiffin, OH, CCN 360089 Hospital Corporate Director Jan 1, 2022
Mercy Health - Willard HospitalWillard, OH, CCN 361310 Hospital Corporate Director Jan 1, 2022
Mercy Health - Willard HospitalWillard, OH, CCN 36Z310 Hospital Corporate Director Jan 1, 2022
Mercy St Charles Acute Inpatient RehabilitationOregon, OH, CCN 36T112 Hospital Corporate Director Jan 1, 2022
Mercy Health - St Vincent Medical Center LLCOregon, OH, CCN 36S112 Hospital Corporate Director Jan 1, 2022
Mercy Health - Tiffin Hospital Primary Care, New WashingtonNew Washington, OH, CCN 363423 Rural health clinic Corporate Director Jan 1, 2022

Owned or controlled facilities with NPI records 8

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

Organizations & group practices 4

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": "1144627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372032000000",
    "number": "1447213673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4750 HEMPSTEAD STATION DR",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454295164",
            "telephone_number": "800-875-0136",
            "fax_number": "937-619-4231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2213 CHERRY ST",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436082603",
            "telephone_number": "419-251-3232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KING",
        "first_name": "RANDALL",
        "middle_name": "W",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-10",
        "last_updated": "2013-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "35047670",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BUCKEYE COMMUNITY NUMBER",
            "identifier": "727073",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104758929",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0540847",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104734103",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS INDIVIDUAL NUMBER",
            "identifier": "000000360656",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS # ST VOBS",
            "identifier": "000000371637",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE NUMBER",
            "identifier": "P00209987",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

Verify at the official NPI Registry.