Active NPI
Robert King, MD
- Surgery Physician
- Grand Forks, ND
National Provider Identifier
1477177293
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- RL16625
- Practice address
- 1301 N Columbia Rd, Stop 9037
Und Department of Surgery
Grand Forks, ND 58202-9037 - Phone
- (701) 293-4151
- NPI assigned
- Jun 8, 2020
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Surgery Physician | 208600000X | RL16625 | ND | Primary |
Addresses
Primary practice location
1301 N Columbia Rd, Stop 9037
Und Department of Surgery
Grand Forks, ND 58202-9037
Mailing address
1301 N Columbia Rd, Stop 9037
Und Department of Surgery
Grand Forks, ND 58202-9037
Phone (701) 293-4151
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RL16625 | ND | MD | Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1591574400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1591574400000",
"number": "1477177293",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1301 N COLUMBIA RD, STOP 9037",
"address_2": "UND DEPARTMENT OF SURGERY",
"city": "GRAND FORKS",
"state": "ND",
"postal_code": "582029037",
"telephone_number": "701-293-4151"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1301 N COLUMBIA RD, STOP 9037",
"address_2": "UND DEPARTMENT OF SURGERY",
"city": "GRAND FORKS",
"state": "ND",
"postal_code": "582029037",
"telephone_number": "701-293-4151"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KING",
"first_name": "ROBERT",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-06-08",
"last_updated": "2020-06-08",
"certification_date": "2020-06-08",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "ND",
"license": "RL16625",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grand Forks, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2020; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.