Individual provider Active NPI

Helen Jelks King, OD

  • Optometrist
  • Quincy, FL
National Provider Identifier
1609847433
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OP1888 Issued in FL
Practice address
21 S Madison St
Quincy, FL 32351-3137
Phone
(850) 627-9521
NPI assigned
Jan 30, 2006
Sex
Female
Sole proprietor
No

Organizations & group practices 1

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.

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

State licenses

LicenseStateTypeSpecialty
OP1888FLMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
North Florida Regional Eyecare, PA Optometrist Past Accepting new patients

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OP1888 FL Primary

Addresses

NPPES NPI Registry

Primary practice location

21 S Madison St
Quincy, FL 32351-3137

Mailing address

1480 Timberlane Rd
Tallahassee, FL 32312-1713
Phone (850) 893-4005

Other practice location 1

1480 Timberlane Rd
Tallahassee, FL 32312-1713
Phone (850) 893-4005

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
0782904MedicaidFL

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Mar 17, 2018.

{
    "created_epoch": "1138579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1609847433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1480 TIMBERLANE RD",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323121713",
            "telephone_number": "850-893-4005",
            "fax_number": "850-893-9987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 S MADISON ST",
            "city": "QUINCY",
            "state": "FL",
            "postal_code": "323513137",
            "telephone_number": "850-627-9521"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1480 Timberlane Rd",
            "address_purpose": "LOCATION",
            "city": "Tallahassee",
            "state": "FL",
            "postal_code": "323121713",
            "country_code": "US",
            "telephone_number": "850-893-4005",
            "fax_number": "850-893-9987",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KING",
        "first_name": "HELEN",
        "middle_name": "JELKS",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-30",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OP1888",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0782904",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Quincy, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.