Mark E King, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

95-PA19 Issued in NM

Practice address

1401 Sudderth Dr
Ruidoso, NM 88345-6104

Phone

(575) 257-7712

Fax

(575) 257-4513

NPI assigned

Sep 27, 2006

Last updated

Apr 3, 2012By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in NM

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

Specialty

Physician Assistant

Education

Other, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St Vincent HospitalGroup PAC ID 6608775135, 335 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Christus St Vincent Regional Medical Center Hospital, Santa Fe, NM, CCN 320002

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• St Vincent Hospital

  dba CHRISTUS St. Vincent Pediatrics

  • Pediatrics Physician
  • Santa Fe, NM
  • NPI 1063367803
  Medicare reassignment Care Compare group
• Curry Emergency Group LLC

  • Emergency Medicine Physician
  • Clovis, NM
  • NPI 1508223082
  Medicare reassignment
• St Vincent Hospital

  dba CHRISTUS St. Vincent Center for Healthy Aging

  • Adult Medicine Physician
  • Santa Fe, NM
  • NPI 1194599712
  NPD
• St. Vincent Hospital

  dba CHRISTUS St. Vincent Adult and Family Care

  • Family Medicine Physician
  • Santa Fe, NM
  • NPI 1245438647
  NPD
• Michael a Rowley MD PA

  • Diagnostic Radiology Physician
  • Clovis, NM
  • NPI 1174716781
  NPD (past)
• Roswell Clinic Corp

  • Family Medicine Physician
  • Roswell, NM
  • NPI 1649267618
  NPD (past)
• Lincoln County Public Hospital District 1

  dba Odessa Rural Health Clinic

  • Rural Health Clinic/Center
  • Odessa, WA
  • NPI 1023122520
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• St Vincent Hospital

  dba CHRISTUS St. Vincent Regional Medical Center

  • General Acute Care Hospital
  • Santa Fe, NM
  • NPI 1578587150
  Care Compare affiliation

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1333411200000",
    "number": "1457442691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 SUDDERTH DR",
            "city": "RUIDOSO",
            "state": "NM",
            "postal_code": "883456104",
            "telephone_number": "575-257-7712",
            "fax_number": "575-257-4513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 SUDDERTH DR",
            "city": "RUIDOSO",
            "state": "NM",
            "postal_code": "883456104",
            "telephone_number": "575-257-7712",
            "fax_number": "575-257-4513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KING",
        "first_name": "MARK",
        "middle_name": "E",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-27",
        "last_updated": "2012-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NM",
            "license": "95-PA19",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WA",
            "license": "10003262",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BSWA",
            "identifier": "3016KI",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LIWA",
            "identifier": "0220796",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "USDLAB",
            "identifier": "605960011",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8464794",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kendal Trujillo DDS PC (Summit Dental)
• Kenneth W Childress DDS PC
• Kenneth Kenney
• Daniel Kesler
• Courtney Ann Kessler, PHARMD
• Virginia V King, BMS
• Heather Kinney, LMHC
• Casey Kirkham, PT
• Bruce Wayne Klinekole, D.C., D.A.C.N.B.
• Chelsey Koch

• Medical Physician Assistant in Ruidoso, NM
• Providers in Ruidoso, NM by specialty
• Medical Physician Assistant in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2012; 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.