Loretha King, DO

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

OS8310 Issued in FL

Practice address

143 Executive Cir
Daytona Beach, FL 32114-1180

Phone

(772) 233-9515

NPI assigned

Feb 26, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

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.

• Son Shine Foot and Ankle Center Inc

  • Foot & Ankle Surgery Podiatrist
  • Port St Lucie, FL
  • NPI 1063459675
  NPD (past)

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

{
    "created_epoch": "1172448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602547200000",
    "number": "1578699351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6101 BLUE LAGOON DR STE 400",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331262051",
            "telephone_number": "305-500-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "143 EXECUTIVE CIR",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321141180",
            "telephone_number": "772-233-9515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KING",
        "first_name": "LORETHA",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-26",
        "last_updated": "2020-10-13",
        "certification_date": "2020-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "OS8310",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "279101300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Myunghwa Kim, ARNP
• Nathan Sung in Kim, MD
• Chloe Kindred
• Carolyn Ann King, MS, CCC/SLP
• Desiree Lorraine King, PSY.D.
• Melissa Marie King, PTA
• Michael Ross King, LPN, NBC-HWC
• Rebecca Jody King, MA
• Brenton Scott Kinker, MD
• Amber Kinney

• General Practice Physician in Daytona Beach, FL
• Providers in Daytona Beach, FL by specialty
• General Practice Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.