Individual provider Active NPI

Elizabeth L King, M.D.

  • Pediatrics Physician
  • Salem, OR
National Provider Identifier
1679505580
Registry record updated Aug 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
ME91162 Issued in FL
Practice address
2478 13TH St SE
Salem, OR 97302-2522
Phone
(503) 362-2481
Fax
(503) 371-7803
NPI assigned
Jul 7, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X ME91162 FL Primary

Addresses

Primary practice location

2478 13TH St SE
Salem, OR 97302-2522

Mailing address

2478 13TH St SE
Salem, OR 97302-2522
Phone (503) 362-2481

Other identifiers 1

IdentifierTypeStateIssuer
270725000MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130905000202 OR Practitioner - Pediatric Medicine 0143284281

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME91162FLMDPediatrics Physician

Interoperability endpoints

  • Direct secure messaging: bethking@direct.wvp.nextgenshare.com

NPI Registry JSON

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377820800000",
    "number": "1679505580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2478 13TH ST SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973022522",
            "telephone_number": "503-362-2481",
            "fax_number": "503-371-7803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2478 13TH ST SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973022522",
            "telephone_number": "503-362-2481",
            "fax_number": "503-371-7803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KING",
        "first_name": "ELIZABETH",
        "middle_name": "L",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-07",
        "last_updated": "2013-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME91162",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "270725000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, OR

Sources for this page

Verify at the official NPI Registry.