NPIMap

Individual provider Active NPI

Gideon Lee King, M.D.

  • Family Medicine Physician
  • Canal Winchester, OH
National Provider Identifier
1548255367
Registry record updated Oct 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
35084584 Issued in OH
Practice address
6201 Gender Rd
Canal Winchester, OH 43110-2007
Phone
(614) 834-8042
Fax
(614) 837-8035
NPI assigned
Sep 19, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 24, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 35084584 OH Primary

Addresses

Primary practice location

6201 Gender Rd
Canal Winchester, OH 43110-2007

Mailing address

6201 Gender Rd
Canal Winchester, OH 43110-2007
Phone (614) 834-8042

Other identifiers 1

IdentifierTypeStateIssuer
2489561MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040818000547 OH Practitioner - Family Practice 5193798056 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Kansas School of Med (KC/Wich/Sal), 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Central Ohio Primary Care Physicians, Inc.Group PAC ID 2769383785, 487 clinicians

Practice addresses (Care Compare)

4885 Olentangy River Rd
Columbus, OH 43214-1952
Phone (614) 326-5665

6201 Gender Rd
Canal Winchester, OH 43110-2007
Phone (614) 834-8042

8050 E Main St
Suite 1200
Reynoldsburg, OH 43068-2575
Phone (614) 259-0923

Hospital & facility affiliations

  • Summit Orthopaedic Home Care Home health agency, Grandview Heights, OH, CCN 368154
  • Grant Medical Center Hospital, Columbus, OH, CCN 360017
  • Diley Ridge Medical Center Hospital, Canal Winchester, OH, CCN 360358
  • Mount Carmel East & West Hospital, Columbus, OH, CCN 360035
  • Berger Hospital Hospital, Circleville, OH, CCN 360170
  • Riverside Methodist Hospital Hospital, Columbus, OH, CCN 360006

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35084584OHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central Ohio Primary Care Physicians, Inc. CurrentSince Dec 31, 2013 Accepting new patients
Central Ohio Primary Care Physicians, Inc. Family Medicine CurrentSince Dec 31, 2013 Accepting new patients
Central Ohio Primary Care Physicians Inc Current Accepting new patients
Mount Vernon Family Practice Inc Family Medicine Past Accepting new patients
Knox Emergency Services, LLC Past Accepting new patients
Dublin Urgent Care Inc Past Accepting new patients

Locations

6201 Gender Rd
Canal Winchester, OH 43110
Phone (614) 585-9900

4885 Olentangy River Rd
Columbus, OH 43214
Phone (614) 326-5665

570 Polaris Pkwy
Ste 250
Westerville, OH 43082
Phone (614) 459-0216

Interoperability endpoints

  • Direct secure messaging: gking18859@copcp.medicity.net
  • Direct secure messaging: ms_gking32@landmarkhealth-direct.org

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 8

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

NPI Registry JSON

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

{
    "created_epoch": "1127088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1382572800000",
    "number": "1548255367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6201 GENDER RD",
            "city": "CANAL WINCHESTER",
            "state": "OH",
            "postal_code": "431102007",
            "telephone_number": "614-834-8042",
            "fax_number": "614-837-8035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6201 GENDER RD",
            "city": "CANAL WINCHESTER",
            "state": "OH",
            "postal_code": "431102007",
            "telephone_number": "614-834-8042",
            "fax_number": "614-837-8035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KING",
        "first_name": "GIDEON",
        "middle_name": "LEE",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-19",
        "last_updated": "2013-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35084584",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2489561",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Canal Winchester, OH

Sources for this page

Verify at the official NPI Registry.