Theresa Renee King, RN, CFNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R873560 Issued in MS

Practice address

427 Highway 51 N
Brookhaven, MS 39601-2350

Phone

(601) 826-5500

Fax

(601) 420-5299

NPI assigned

Sep 8, 2006

Last updated

Oct 20, 2015By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Theresa Renee King Former name

Medicare fee-for-service enrollment

Enrolled in MS

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner, Registered Nurse

State licenses

Practice roles

Locations

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

• Harrison Emergency Group LLC

  • Emergency Medicine Physician
  • Biloxi, MS
  • NPI 1467410936
  Medicare reassignment NPD
• Hattiesburg Urgent Care, LLC

  • Urgent Care Clinic/Center
  • Hattiesburg, MS
  • NPI 1164805156
  Medicare reassignment NPD
• Maxem Health Urgent Care Diberville

  • Urgent Care Clinic/Center
  • D'Iberville, MS
  • NPI 1265991608
  Medicare reassignment NPD
• Maxem Health Urgent Care Flowood

  dba Flowood Urgent Care

  • Urgent Care Clinic/Center
  • Flowood, MS
  • NPI 1174070650
  Medicare reassignment NPD
• Ocean Springs Urgent Care

  • Urgent Care Clinic/Center
  • Ocean Springs, MS
  • NPI 1871808022
  Medicare reassignment NPD
• Orange Grove Urgent Care

  • Urgent Care Clinic/Center
  • Gulfport, MS
  • NPI 1831330661
  Medicare reassignment NPD
• App of Mississippi Ed, LLC

  • Emergency Medicine Physician
  • Jackson, MS
  • NPI 1730687740
  Medicare reassignment
• Nurse Practitioner Professionals, PLLC

  dba Theresa Renee King

  • Ambulatory Surgical Clinic/Center
  • Brookhaven, MS
  • NPI 1205218690
  Authorized official Same address or phone
• Gulfport 49 Imaging, LLC

  • Radiology Clinic/Center
  • Gulfport, MS
  • NPI 1134702301
  NPD
• Patients Choice Medical Center of Humphreys County, LLC

  • Critical Access Hospital
  • Belzoni, MS
  • NPI 1114951324
  NPD (past)
• Trustcare Health, LLC

  dba Trust Care Health

  • Family Medicine Physician
  • Ridgeland, MS
  • NPI 1427338235
  NPD (past)
• Trustcare Primary Care, LLC

  dba TrustCare Health, LLC

  • Family Medicine Physician
  • Madison, MS
  • NPI 1174078554
  NPD (past)

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

{
    "created_epoch": "1157673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445299200000",
    "number": "1669576989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1805",
            "city": "BRANDON",
            "state": "MS",
            "postal_code": "390431805",
            "telephone_number": "601-826-5500",
            "fax_number": "601-420-5299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "427 HIGHWAY 51 N",
            "city": "BROOKHAVEN",
            "state": "MS",
            "postal_code": "396012350",
            "telephone_number": "601-826-5500",
            "fax_number": "601-420-5299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KING",
        "first_name": "THERESA",
        "middle_name": "RENEE",
        "credential": "RN, CFNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-08",
        "last_updated": "2015-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R873560",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02572058",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "THERESA",
            "last_name": "KING",
            "middle_name": "RENEE",
            "credential": "RN, CFNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Holly L Kimbrell, CFNP
• Sarah Kathryn Kimes
• Kindness Healthcare Services LLC
• Jaci King
• Jeremy Drew King, D.M.D.
• King's Daughters Medial Center
• King's Daughters Medial Center
• King's Daughters Medical Center (King's Daughters Primary Care Clinic)
• King's Daughters Medical Center (King's Daughters Medical Clinic)
• King's Daughters Medical Center (KDMC Pediatric Adolescent Clinic)

• Family Nurse Practitioner in Brookhaven, MS
• Providers in Brookhaven, MS by specialty
• Family Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.