Individual provider Active NPI

Thomas B King, MD

  • Psychiatry Physician
  • Wheat Ridge, CO
National Provider Identifier
1609806876
Registry record updated Oct 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
19430 Issued in CO
Practice address
4045 Wadsworth Blvd
Ste 308
Wheat Ridge, CO 80033-4642
Phone
(720) 328-6119
Fax
(303) 432-1936
NPI assigned
Jul 4, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 29, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 19430 CO Primary

Addresses

Primary practice location

4045 Wadsworth Blvd
Ste 308
Wheat Ridge, CO 80033-4642

Mailing address

4045 Wadsworth Blvd
Ste 308
Wheat Ridge, CO 80033-4642
Phone (720) 328-6119

Other identifiers 1

IdentifierTypeStateIssuer
01194307MedicaidCO

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
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
19430COMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1288310400000",
    "number": "1609806876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4045 WADSWORTH BLVD",
            "address_2": "STE 308",
            "city": "WHEAT RIDGE",
            "state": "CO",
            "postal_code": "800334642",
            "telephone_number": "720-328-6119",
            "fax_number": "303-432-1936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4045 WADSWORTH BLVD",
            "address_2": "STE 308",
            "city": "WHEAT RIDGE",
            "state": "CO",
            "postal_code": "800334642",
            "telephone_number": "720-328-6119",
            "fax_number": "303-432-1936"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KING",
        "first_name": "THOMAS",
        "middle_name": "B",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-04",
        "last_updated": "2010-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CO",
            "license": "19430",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01194307",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wheat Ridge, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2010; 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.