Active NPI
Amy L King, M.D.
- Specialist
- Myrtle Beach, SC
National Provider Identifier
1740276971
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 22549
- Practice address
- 4378 Oleander Dr
Myrtle Beach, SC 29577 - Phone
- (843) 839-4996
- Fax
- (843) 839-5427
- NPI assigned
- Sep 22, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 22549 | SC | Primary |
Addresses
Primary practice location
4378 Oleander Dr
Myrtle Beach, SC 29577
Mailing address
4378 Oleander Dr
Myrtle Beach, SC 29577
Phone (843) 839-4996
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| T69486 | Medicaid | SC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Apr 1, 2020 through Apr 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1127347200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1740276971",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4378 OLEANDER DR",
"city": "MYRTLE BEACH",
"state": "SC",
"postal_code": "29577",
"telephone_number": "843-839-4996",
"fax_number": "843-839-5427"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4378 OLEANDER DR",
"city": "MYRTLE BEACH",
"state": "SC",
"postal_code": "29577",
"telephone_number": "843-839-4996",
"fax_number": "843-839-5427"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KING",
"first_name": "AMY",
"middle_name": "L",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-09-22",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "SC",
"license": "22549",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "T69486",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Myrtle Beach, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.