Thomas King, FNP
Individual provider Active NPI Family Nurse Practitioner · Jamestown, CA
NPI 1497005268 · NPPES record last updated Aug 25, 2025
Key facts
- NPI
- 1497005268
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 784345 (CA)
- Practice address
- 18232 Smoke St
Jamestown, CA 95327-9218 - Phone
- (209) 984-4820
- NPI assigned
- Sep 19, 2012
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in CA, TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20161019002880 | CA | Practitioner - Nurse Practitioner | 8123316403 | |
| I20201106000062 | TX | Practitioner - Nurse Practitioner | 8123316403 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 785345 | CA | MD | Critical Care Medicine Registered Nurse |
| 784345 | CA | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mathiesen Memorial Health Clinic | Current |
Accepting new patients | |
| Mathiesen Memorial Health Center | Past |
Accepting new patients |
Locations
18232 Smoke St
Jamestown, CA 95327
Phone (209) 782-8625
Interoperability endpoints
- https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
- thomas.king.p1@direct.mathiesenmemorialhc.nextgenshare.com
- thomas.king.p3@direct.mathiesenmemorialhc.nextgenshare.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Critical Care Medicine Registered Nurse | 163WC0200X | 785345 | CA | |
| Pain Management Registered Nurse | 163WP0000X | 95000245 | CA | |
| Nurse Practitioner | 363L00000X | 95000245 | CA | |
| Family Nurse Practitioner | 363LF0000X | 784345 | CA | Yes |
Addresses
Primary practice location
18232 Smoke St
Jamestown, CA 95327-9218
Mailing address
19875 Whitto Mine Rd
Sonora, CA 95370-8405
Other practice location 1
22902 Twain Harte Dr
Twain Harte, CA 95383-9597
Phone (209) 770-3236
Other practice location 2
18144 Seco St
Jamestown, CA 95327-9498
Phone (209) 984-4820
Other providers in Jamestown, CA
- Sheryl Allene Goularte
- Richard Perry Halliburton
- Glenda Jean Henderson-Balmet
- Jamestown School District
- Haku Kevin Kahoano
- Jeffrey Frank Kocher
- Michelle J Low
- Blong Roger Ly
- Alejandro Gastello Martinez
- Mathiesen Memorial Health Center
All providers in Jamestown, CA · Family Nurse Practitioner in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 25, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.