Active NPI
Richard M King, PT
- Physical Therapist
- Grand Coulee, WA
National Provider Identifier
1467542894
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT00003909
- Practice address
- 321 Burdin Blvd
Grand Coulee, WA 99133-0680 - Phone
- (509) 633-3260
- Fax
- (509) 633-3212
- NPI assigned
- Oct 14, 2006
- Last updated
- Jun 11, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT00003909 | WA | Primary |
Addresses
Primary practice location
321 Burdin Blvd
Grand Coulee, WA 99133-0680
Mailing address
411 Fortuyn Rd
Grand Coulee, WA 99133
Phone (509) 633-3260
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1044342 | Medicaid | WA | |
| 337847 | Other | WA | L&I |
| G8951875 | Other | WA | MDCR |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 025208 | WA | MD | Cardiovascular Disease Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Douglas, Grant, Lincoln & Okanogan Counties Public Hospital District 6 | Current | Accepting new patients | |
| Douglas, Grant, Lincoln & Okanogan Counties Public Hospital District 6 | Current | Accepting new patients | |
| Douglas, Grant, Lincoln & Okanogan Counties Public Hospital District 6 | Current | Accepting new patients | |
| Douglas, Grant, Lincoln & Okanogan Counties Public Hospital District 6 | Past | Accepting new patients |
Locations
411 Fortuyn Rd
Grand Coulee, WA 99133
Phone (509) 633-1753
Interoperability endpoints
- kingr@cmccares.cernerdirect.com
Organizations & group practices 5
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.
-
- Family Medicine Physician
- Grand Coulee, WA
- NPI 1265422935
-
- Physical Therapist
- Grand Coulee, WA
- NPI 1477726438
-
- Critical Access Hospital
- Grand Coulee, WA
- NPI 1184844185
-
dba Coulee Medical Center
- Medicare Defined Swing Bed Hospital Unit
- Grand Coulee, WA
- NPI 1699851840
-
dba Coulee Medical Center
- Rural Health Clinic/Center
- Grand Coulee, WA
- NPI 1457420218
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160784000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1560211200000",
"number": "1467542894",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "411 FORTUYN RD",
"city": "GRAND COULEE",
"state": "WA",
"postal_code": "99133",
"telephone_number": "509-633-3260",
"fax_number": "509-633-3212"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "321 BURDIN BLVD",
"city": "GRAND COULEE",
"state": "WA",
"postal_code": "991330680",
"telephone_number": "509-633-3260",
"fax_number": "509-633-3212"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KING",
"first_name": "RICHARD",
"middle_name": "M",
"name_prefix": "Mr.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-14",
"last_updated": "2019-06-11",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WA",
"license": "PT00003909",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1044342",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "L&I",
"identifier": "337847",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MDCR",
"identifier": "G8951875",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Grand Coulee, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; 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.