Individual provider Active NPI

Marjorie Eliizabeth King, FNP/APRN

  • Family Nurse Practitioner
  • Milford, CT
National Provider Identifier
1447448477
Registry record updated Jan 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
8034 Issued in CT
Practice address
256 Seaside Ave
Milford, CT 06460-4602
Phone
(203) 693-2320
NPI assigned
Oct 3, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN118082 AZ
Family Nurse Practitioner 363LF0000X 8034 CT Primary

Addresses

Primary practice location

256 Seaside Ave
Milford, CT 06460-4602

Mailing address

256 Seaside Ave
Milford, CT 06460-4602
Phone (203) 693-2320

Other practice location 1

3939 S Ave 3 E
119-123
Yuma, AZ 85365-5512
Phone (928) 341-4544

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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 1

Enrollment IDStateProvider typePAC IDDetails
I20190124003694 CT Practitioner - Nurse Practitioner 0840366282 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pain Management Partners LLCGroup PAC ID 8426488081, 7 clinicians

Practice addresses (Care Compare)

1320 W Main St
BLDG 2 Unit 5
Waterbury, CT 06708-3119
Phone (203) 518-8414

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
8034CTMDMassage Therapist
RN118082AZMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Horizon Healthcare Family Past Accepting new patients

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": "1191369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546992000000",
    "number": "1447448477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "256 SEASIDE AVE",
            "city": "MILFORD",
            "state": "CT",
            "postal_code": "064604602",
            "telephone_number": "203-693-2320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "256 SEASIDE AVE",
            "city": "MILFORD",
            "state": "CT",
            "postal_code": "064604602",
            "telephone_number": "203-693-2320"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3939 S Ave 3 E",
            "address_2": "119-123",
            "address_purpose": "LOCATION",
            "city": "Yuma",
            "state": "AZ",
            "postal_code": "853655512",
            "country_code": "US",
            "telephone_number": "928-341-4544",
            "fax_number": "928-341-4514",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KING",
        "first_name": "MARJORIE",
        "middle_name": "ELIIZABETH",
        "credential": "FNP/APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-03",
        "last_updated": "2019-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "RN118082",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "8034",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milford, CT

Sources for this page

Verify at the official NPI Registry.