Kelley L King, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

4401 Bradshaw Rd
Sacramento, CA 95827-3835

Phone

(916) 732-5243

Fax

(916) 366-3206

NPI assigned

Jan 26, 2006

Last updated

Mar 17, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

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

Specialty

Physician Assistant

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Sutter Valley Medical FoundationGroup PAC ID 9830094515, 2,473 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sutter Care at Home Home health agency, Sacramento, CA, CCN 557073
• United Home Care of Northern California Home health agency, Jackson, CA, CCN 557014
• Sutter Amador Hospital Hospital, Jackson, CA, CCN 050014
• Sutter Medical Center, Sacramento Hospital, Sacramento, CA, CCN 050108

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/19482/brand/1/csg/1/fhir/r4
• Direct secure messaging: kking210851@hisp.ehr.sutterhealth.org

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.

• Sutter Valley Medical Foundation

  dba Sutter Gould Medical Foundation

  • Multi-Specialty Clinic/Center
  • Modesto, CA
  • NPI 1669846986
  Medicare reassignment Care Compare group NPD
• Sutter Valley Medical Foundation

  • Durable Medical Equipment & Medical Supplies
  • Tracy, CA
  • NPI 1720930712
  NPD
• Mathiesen Memorial Health Center

  • Primary Care Clinic/Center
  • Jamestown, CA
  • NPI 1356080022
  NPD (past)
• Sutter Regional Medical Foundation

  • Family Medicine Physician
  • Fairfield, CA
  • NPI 1558388504

  Physician Assistant

  NPD (past)
• United Indian Health Services, Inc.

  • Primary Care Clinic/Center
  • Eureka, CA
  • NPI 1588660104
  NPD (past)
• United Indian Health Services, Inc.

  • Community Health Clinic/Center
  • Arcata, CA
  • NPI 1699506121
  NPD (past)
• Urology Nevada LTD

  dba Urology Nevada

  • Urology Physician
  • Reno, NV
  • NPI 1316162795
  NPD (past)

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

• Sutter Valley Hospitals

  dba Sutter Amador Hospital

  • General Acute Care Hospital
  • Jackson, CA
  • NPI 1447494323
  Care Compare affiliation
• Sutter Valley Hospitals

  • General Acute Care Hospital
  • Sacramento, CA
  • NPI 1811946734
  Care Compare affiliation
• Sutter Visiting Nurse Association and Hospice

  dba Sutter Care at Home

  • Home Health Agency
  • Sacramento, CA
  • NPI 1649209412
  Care Compare affiliation
• United Homecare of Northern California, LC

  dba Amador Home Health

  • Home Health Agency
  • Jackson, CA
  • NPI 1174520027
  Care Compare affiliation

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

{
    "created_epoch": "1138233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1760452130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10470 OLD PLACERVILLE RD",
            "address_2": "SUITE 100",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958272539",
            "telephone_number": "800-470-0071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4401 BRADSHAW RD",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958273835",
            "telephone_number": "916-732-5243",
            "fax_number": "916-366-3206"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "770 Mason St",
            "address_purpose": "LOCATION",
            "city": "Vacaville",
            "state": "CA",
            "postal_code": "956884646",
            "country_code": "US",
            "telephone_number": "707-454-5800",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2020 Sutter Pl Ste 101",
            "address_purpose": "LOCATION",
            "city": "Davis",
            "state": "CA",
            "postal_code": "956166217",
            "country_code": "US",
            "telephone_number": "530-750-5830",
            "fax_number": "530-750-5891",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KING",
        "first_name": "KELLEY",
        "middle_name": "L",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-26",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "PA17317",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eric Chonhun King, M.D.
• Erica Bobbie King, LMFT
• Galen Lindsey King, DDS
• Gregory A King
• Hayden King
• Koleka King
• Lauren Antje King
• Leamon King, BFA
• Lyndin King
• Michelle King

• Physician Assistant in Sacramento, CA
• Providers in Sacramento, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.