Active NPI
Michael King, PA
- Physician Assistant
- West Valley City, UT
National Provider Identifier
1477514446
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 104534-1206
- Practice address
- 3460 Pioneer Pkwy
West Valley City, UT 84120-2049 - Phone
- (801) 964-3100
- NPI assigned
- Mar 30, 2006
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 104534-1206 | UT | Primary |
Addresses
Primary practice location
3460 Pioneer Pkwy
West Valley City, UT 84120-2049
Mailing address
370 E South Temple
Ste 260
Salt Lake City, UT 84111-1206
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 104534-1206 | UT | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1143676800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1188950400000",
"number": "1477514446",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "370 E SOUTH TEMPLE",
"address_2": "STE 260",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841111206"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3460 PIONEER PKWY",
"city": "WEST VALLEY CITY",
"state": "UT",
"postal_code": "841202049",
"telephone_number": "801-964-3100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KING",
"first_name": "MICHAEL",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-30",
"last_updated": "2007-09-05",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "UT",
"license": "104534-1206",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Valley City, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.