Individual provider Active NPI

Kimberly Rae King, AU.D.

  • Audiologist
  • North Myrtle Beach, SC
National Provider Identifier
1720057011
Registry record updated Jun 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
3045 Issued in SC
Practice address
640 6TH Ave S
North Myrtle Beach, SC 29582-3310
Phone
(843) 663-4327
Fax
(843) 663-3277
NPI assigned
Mar 17, 2006
Last updated
Jun 12, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 3045 SC Primary

Addresses

Primary practice location

640 6TH Ave S
North Myrtle Beach, SC 29582-3310

Mailing address

640 6TH Ave S
North Myrtle Beach, SC 29582-3310
Phone (843) 663-4327

Other identifiers 3

IdentifierTypeStateIssuer
87726OtherSCUNITEDHEALTHCARE
SA0405MedicaidSC
Q325400281OtherSCBCBS OF SC

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)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Hearing Solutions, LLC Past Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1142553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213228800000",
    "number": "1720057011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "640 6TH AVE S",
            "city": "NORTH MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295823310",
            "telephone_number": "843-663-4327",
            "fax_number": "843-663-3277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 6TH AVE S",
            "city": "NORTH MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295823310",
            "telephone_number": "843-663-4327",
            "fax_number": "843-663-3277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KING",
        "first_name": "KIMBERLY",
        "middle_name": "RAE",
        "name_prefix": "Dr.",
        "credential": "AU.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-17",
        "last_updated": "2008-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "SC",
            "license": "3045",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITEDHEALTHCARE",
            "identifier": "87726",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SA0405",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF SC",
            "identifier": "Q325400281",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Myrtle Beach, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2008; 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.