Individual provider Active NPI

Kathryn L King, FNP

  • Family Nurse Practitioner
  • Collierville, TN
National Provider Identifier
1740591437
Registry record updated Feb 1, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN88008 Issued in TN
Practice address
2028 W Poplar Ave
Ste 112
Collierville, TN 38017-0618
Phone
(901) 866-8372
Fax
(901) 302-2372
NPI assigned
Jun 28, 2010
Last updated
Feb 1, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN88008 TN Primary

Addresses

Primary practice location

2028 W Poplar Ave
Ste 112
Collierville, TN 38017-0618

Mailing address

2028 W Poplar Ave
Ste 112
Collierville, TN 38017-0618
Phone (901) 866-8372

Other identifiers 1

IdentifierTypeStateIssuer
1519558MedicaidTN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100820000126 TN Practitioner - Nurse Practitioner 3375677727 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Tennessee, HSC, College of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The West Clinic P.C.Group PAC ID 2668360579, 115 clinicians

Practice addresses (Care Compare)

1588 Union Ave
Memphis, TN 38104-3729
Phone (901) 300-1562

240 Grandview Dr
Brighton, TN 38011-4253
Phone (901) 475-0678

7945 Wolf River Blvd
Germantown, TN 38138-1762
Phone (901) 683-0055

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.15 of 100Reported as subgroup
Quality
83.22
Promoting interoperability
100
Improvement activities
40
Cost
77.26

Merit-based Incentive Payment System (MIPS)

Final score
89.26 of 100Reported as group
Quality
89.71
Improvement activities
40
Cost
77.91

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN88008TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The West Clinic P.C. CurrentSince Oct 16, 2019 Accepting new patients
The West Clinic P.C. CurrentSince Oct 16, 2019 Accepting new patients
Shea Clinic CurrentSince Sep 1, 2022 Accepting new patients
Shea Clinic CurrentSince Sep 1, 2022 Accepting new patients

Locations

1588 Union Ave
Memphis, TN 38104
Phone (901) 276-2410

6133 Poplar Pike
Memphis, TN 38119
Phone (901) 737-8571

7945 Wolf River Blvd
Memphis, TN 38138
Phone (901) 448-7000

Interoperability endpoints

  • Direct secure messaging: kking@sheaclinic.gwaydirect.com
  • Direct secure messaging: kking28583@mlh.direct-ci.com

Organizations & group practices 5

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1277683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485907200000",
    "number": "1740591437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2028 W POPLAR AVE",
            "address_2": "STE 112",
            "city": "COLLIERVILLE",
            "state": "TN",
            "postal_code": "380170618",
            "telephone_number": "901-866-8372",
            "fax_number": "901-302-2372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2028 W POPLAR AVE",
            "address_2": "STE 112",
            "city": "COLLIERVILLE",
            "state": "TN",
            "postal_code": "380170618",
            "telephone_number": "901-866-8372",
            "fax_number": "901-302-2372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KING",
        "first_name": "KATHRYN",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-28",
        "last_updated": "2017-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "RN88008",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1519558",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Collierville, TN

Sources for this page

Verify at the official NPI Registry.