Individual provider Active NPI

William Drawdy King, MD

  • Internal Medicine Physician
  • Coos Bay, OR
National Provider Identifier
1740264399
Registry record updated Mar 23, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD13871 Issued in OR
Practice address
1900 Woodland Dr
Coos Bay, OR 97420-0000
Phone
(541) 267-5151
Fax
(541) 266-4511
NPI assigned
Dec 6, 2005
Last updated
Mar 23, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 23, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD13871 OR Primary

Addresses

Primary practice location

1900 Woodland Dr
Coos Bay, OR 97420-0000

Mailing address

1900 Woodland Dr
Coos Bay, OR 97420-0000
Phone (541) 267-5151

Other identifiers 5

IdentifierTypeStateIssuer
200956MedicaidOR
R0000WFBTVOtherORMEDICARE GROUP PIN NUMBER
1407812365OtherORNBMC NPI NUMBER-GROUP
CB3544OtherORRR MEDICARE GROUP NUMBER
P00275974OtherORRR MEDICARE PTAN NUMBER

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
I20051024000407 OR Practitioner - Internal Medicine 3476579913 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD13871ORMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Bend Medical Center Inc CurrentSince Nov 14, 2005 Accepting new patients
Bay Area Hospital District Current Accepting new patients
North Bend Medical Center Inc CurrentSince Nov 14, 2005 Accepting new patients

Locations

Dept LA 25339
Pasadena, CA 91185

1900 Woodland Dr
Coos Bay, OR 97420
Phone (541) 267-5151

2650 N 17th St
Coos Bay, OR 97420
Phone (541) 267-5411

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": "1133827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1269302400000",
    "number": "1740264399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 WOODLAND DR",
            "city": "COOS BAY",
            "state": "OR",
            "postal_code": "974200000",
            "telephone_number": "541-267-5151",
            "fax_number": "541-266-4511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 WOODLAND DR",
            "city": "COOS BAY",
            "state": "OR",
            "postal_code": "974200000",
            "telephone_number": "541-267-5151",
            "fax_number": "541-266-4511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KING",
        "first_name": "WILLIAM",
        "middle_name": "DRAWDY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-06",
        "last_updated": "2010-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "MD13871",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200956",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP PIN NUMBER",
            "identifier": "R0000WFBTV",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NBMC NPI NUMBER-GROUP",
            "identifier": "1407812365",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE GROUP NUMBER",
            "identifier": "CB3544",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE PTAN NUMBER",
            "identifier": "P00275974",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Coos Bay, OR

Sources for this page

Verify at the official NPI Registry.