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Organization Active NPI

Kings Daughters Medical Specialties Inc

Doing business as Kings Daughters Medical Specialities Physical Medicine and Rehab

  • Physical Medicine & Rehabilitation Physician
  • Prestonsburg, KY
National Provider Identifier
1710215736
Registry record updated Aug 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
Legal business name
KINGS DAUGHTERS MEDICAL SPECIALTIES INC
Doing business as
Kings Daughters Medical Specialities Physical Medicine and Rehab
Practice address
1279 Old Abbott Mountain Rd
Prestonsburg, KY 41653-1889
Phone
(606) 886-1260
Fax
(606) 886-0892
NPI assigned
Dec 2, 2009
Last updated
Aug 28, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2024

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

Authorized official

Name
Sara Marks
Title
Ceo/President
Phone
(606) 408-4401

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU
Nurse Practitioner 363L00000X NU
Internal Medicine Physician 207R00000X NU
Physical Medicine & Rehabilitation Physician 208100000X NU Primary

Addresses

Primary practice location

1279 Old Abbott Mountain Rd
Prestonsburg, KY 41653-1889

Mailing address

PO Box 2379
Ashland, KY 41105-2379
Phone (606) 408-6200

Other practice location 1

617 23rd St Ste 400
Ashland, KY 41101-2880
Phone (606) 886-0892

Other identifiers 1

IdentifierTypeStateIssuer
7100103220MedicaidKY

Other names 1

  • Kings Daughters Medical Specialities Physical Medicine and Rehab Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, KY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100114000813 OH Part B Supplier - Clinic/Group Practice 6103968029 Receives reassigned benefits from 181 practitioners
24 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Wheelersburg, OH; Waverly, OH; South Point, OH; Portsmouth, OH; Lucasville, OH; Jackson, OH; Ironton, OH; Franklin Furance, OH
O20100217000538 KY Part B Supplier - Clinic/Group Practice 6103968029 Receives reassigned benefits from 554 practitioners
27 other NPIs on this enrollment

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 33

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 33

National Provider Directory

National Provider Directory
Tax ID family
Kings Daughters Medical Specialties Inc23 organizations share this tax ID, including this one

Other organizations with this tax ID 22

Organizations that report the same tax identification number in the National Provider Directory.

View all 22

Locations

1180 Saint Christopher Dr
#1
Ashland, KY 41101
Phone (606) 833-6397

336 29th St
Ste 100
Ashland, KY 41101
Phone (606) 324-4404

1729 Kinneys Ln
Ste 202
Portsmouth, OH 45662
Phone (740) 353-8100

Practitioners & affiliated clinicians

Practitioners 570

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 570

NPI Registry JSON

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

{
    "created_epoch": "1259712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724803200000",
    "number": "1710215736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2379",
            "city": "ASHLAND",
            "state": "KY",
            "postal_code": "411052379",
            "telephone_number": "606-408-6200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1279 OLD ABBOTT MOUNTAIN RD",
            "city": "PRESTONSBURG",
            "state": "KY",
            "postal_code": "416531889",
            "telephone_number": "606-886-1260",
            "fax_number": "606-886-0892"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "617 23rd St Ste 400",
            "address_purpose": "LOCATION",
            "city": "Ashland",
            "state": "KY",
            "postal_code": "411012880",
            "country_code": "US",
            "telephone_number": "606-886-0892",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "KINGS DAUGHTERS MEDICAL SPECIALTIES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-02",
        "last_updated": "2024-08-28",
        "certification_date": "2024-08-28",
        "status": "A",
        "authorized_official_last_name": "MARKS",
        "authorized_official_first_name": "SARA",
        "authorized_official_title_or_position": "CEO/PRESIDENT",
        "authorized_official_telephone_number": "606-408-4401"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100103220",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kings Daughters Medical Specialities Physical Medicine and Rehab",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Prestonsburg, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.