Active NPI
Oliver W. King, M.D
- Specialist
- Marietta, GA
National Provider Identifier
1669465472
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- D29931
- Practice address
- 61 Whitcher Street NE
Suite 2100
Marietta, GA 30060-1179 - Phone
- (770) 423-0595
- Fax
- (770) 874-1614
- NPI assigned
- Aug 26, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | D29931 | GA | Primary |
Addresses
Primary practice location
61 Whitcher Street NE
Suite 2100
Marietta, GA 30060-1179
Mailing address
1505 Stonebridge Parkway
Suite 100
Woodstock, GA 30189-8282
Phone (770) 423-0595
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00085775E | Medicaid | AR |
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
| License | State | Type | Specialty |
|---|---|---|---|
| D29931 | GA | MD | Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Quantum Radiology, PC | Past | Accepting new patients | |
| Vascular Surgical Associates, PC | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Diagnostic Radiology Physician
- Marietta, GA
- NPI 1366495988
-
- Vascular Surgery Physician
- Marietta, GA
- NPI 1114083532
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1125014400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1334102400000",
"number": "1669465472",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1505 STONEBRIDGE PARKWAY",
"address_2": "SUITE 100",
"city": "WOODSTOCK",
"state": "GA",
"postal_code": "301898282",
"telephone_number": "770-423-0595",
"fax_number": "770-874-1614"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "61 WHITCHER STREET NE",
"address_2": "SUITE 2100",
"city": "MARIETTA",
"state": "GA",
"postal_code": "300601179",
"telephone_number": "770-423-0595",
"fax_number": "770-874-1614"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KING",
"first_name": "OLIVER",
"middle_name": "W.",
"name_prefix": "Dr.",
"credential": "M.D",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-08-26",
"last_updated": "2012-04-11",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "GA",
"license": "D29931",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00085775E",
"state": "AR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Marietta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.