Dwight Frederick King, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

64172 Issued in TN

Practice address

3326 Georgia Ave NW
Washington, DC 20010-2562

Phone

(202) 722-0122

Fax

(202) 722-0123

NPI assigned

Aug 3, 2005

Last updated

Jul 14, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in TN

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

Specialty

Psychiatry

Education

Other, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

River Region Psychiatry Associates, LLCGroup PAC ID 1254491012, 118 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• River Region Psychiatry Associates LLC

  dba Ally Psychiatry

  • Psychiatry Physician
  • Montgomery, AL
  • NPI 1386891497

  TN

  Medicare reassignment Care Compare group NPD
• Metropolitan Assessment and Renewal Centers LLC

  • Physician Office Based Coding Specialist
  • Washington, DC
  • NPI 1023604154
  NPD

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

{
    "created_epoch": "1123027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657756800000",
    "number": "1679574313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1104 W 8TH ST",
            "city": "YANKTON",
            "state": "SD",
            "postal_code": "570783306",
            "telephone_number": "605-665-7841",
            "fax_number": "605-665-0546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3326 GEORGIA AVE NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200102562",
            "telephone_number": "202-722-0122",
            "fax_number": "202-722-0123"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1104 W 8th St",
            "address_purpose": "LOCATION",
            "city": "Yankton",
            "state": "SD",
            "postal_code": "570783306",
            "country_code": "US",
            "telephone_number": "605-665-7841",
            "fax_number": "605-665-0546",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1325 W Main St Ste 107",
            "address_purpose": "LOCATION",
            "city": "Franklin",
            "state": "TN",
            "postal_code": "370643786",
            "country_code": "US",
            "telephone_number": "629-333-3820",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KING",
        "first_name": "DWIGHT",
        "middle_name": "FREDERICK",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-03",
        "last_updated": "2022-07-14",
        "certification_date": "2022-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "SD",
            "license": "4624",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TN",
            "license": "64172",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q074866",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6100620",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Clyde King III
• Corlena Shanta King
• Daniel Robert King, M.D.
• Danita King
• David Rosher King, M.D.
• Erika King
• Evelyn King
• Francisco C King, M.D.
• Helene Ward King, PH.D.
• James Louis King

• Psychiatry Physician in Washington, DC
• Providers in Washington, DC by specialty
• Psychiatry Physician in District of Columbia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.