Individual provider Active NPI

Kevan King, PHARMD

  • Emergency Medicine Pharmacist
  • St Augustine, FL
National Provider Identifier
1679366652
Registry record updated May 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PharmacistTaxonomy code 1835E0208X
License
PS64365 Issued in FL
Practice address
400 Health Park Blvd
St Augustine, FL 32086-5784
Phone
(904) 819-5155
Fax
(904) 819-4911
NPI assigned
May 23, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Pharmacist 1835E0208X PS64365 FL Primary

Addresses

Primary practice location

400 Health Park Blvd
St Augustine, FL 32086-5784

Mailing address

124 Savanna Preserve CT
St Augustine, FL 32095-8927
Phone (321) 543-5283

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)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
PS64365FLMDMedical license number

NPI Registry JSON

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

{
    "created_epoch": "1747958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747958400000",
    "number": "1679366652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 SAVANNA PRESERVE CT",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320958927",
            "telephone_number": "321-543-5283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 HEALTH PARK BLVD",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320865784",
            "telephone_number": "904-819-5155",
            "fax_number": "904-819-4911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KING",
        "first_name": "KEVAN",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-05-23",
        "last_updated": "2025-05-23",
        "certification_date": "2025-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835E0208X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Emergency Medicine",
            "state": "FL",
            "license": "PS64365",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Augustine, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2025; 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.