Individual provider Active NPI

William Mack King IV, PHARMD

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • Wilmington, NC
National Provider Identifier
1700212552
Registry record updated May 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X
License
23578 Issued in NC
Practice address
1725 New Hanover Medical Park Dr
Wilmington, NC 28403-5345
Phone
(910) 662-9300
Fax
(910) 662-2401
NPI assigned
Sep 24, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 26, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X 23578 NC Primary

Addresses

Primary practice location

1725 New Hanover Medical Park Dr
Wilmington, NC 28403-5345

Mailing address

PO Box 936857
Atlanta, GA 31193-6857

Other practice location 1

2131 S 17th St
Pharmacy
Wilmington, NC 28401-7407
Phone (910) 662-9358

Other names 1

  • Mackie King Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mking76639@direct.nhrmc.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190118001616 NC Order and Referring Only - Other (Non-Physician) 4385980960

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
23578NCMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

Interoperability endpoints

  • Direct secure messaging: mking1084071@direct.novanthealth.org

NPI Registry JSON

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

{
    "created_epoch": "1379980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621987200000",
    "number": "1700212552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 936857",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "311936857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1725 NEW HANOVER MEDICAL PARK DR",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284035345",
            "telephone_number": "910-662-9300",
            "fax_number": "910-662-2401"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2131 S 17th St",
            "address_2": "Pharmacy",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "NC",
            "postal_code": "284017407",
            "country_code": "US",
            "telephone_number": "910-662-9358",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KING",
        "first_name": "WILLIAM",
        "middle_name": "MACK",
        "name_prefix": "Dr.",
        "name_suffix": "IV",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-09-24",
        "last_updated": "2021-05-26",
        "certification_date": "2021-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "NC",
            "license": "23578",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mking76639@direct.nhrmc.org",
            "affiliation": "N",
            "address_1": "1725 New Hanover Medical Park Dr",
            "city": "Wilmington",
            "state": "NC",
            "country_code": "US",
            "postal_code": "284035345",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "MACKIE",
            "last_name": "KING",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Wilmington, NC

Sources for this page

Verify at the official NPI Registry.