King 1959, Inc.

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

KING 1959, INC.

Practice address

2055 Gees Mill Rd NE Ste 313
Conyers, GA 30013-1363

Phone

(770) 689-9788

NPI assigned

May 15, 2018

Organization subpart

No

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

Authorized official

Name

Mr. Mark Shannon ThomasNPI 1811233794

Title

Ceo

Phone

(770) 689-9788

Specialties & licenses 1

Addresses

Other names 1

• Diabetic Relief Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mark Shannon Thomas

  • Surgical Technologist
  • Snellville, GA
  • NPI 1811233794
  NPD (past) Authorized official

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

{
    "created_epoch": "1526342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1526342400000",
    "number": "1780174821",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4002 HIGHWAY 78 W # 530-242",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300397915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2055 GEES MILL RD NE STE 313",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300131363",
            "telephone_number": "770-689-9788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KING 1959, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-15",
        "last_updated": "2018-05-15",
        "status": "A",
        "authorized_official_last_name": "THOMAS",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "SHANNON",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "770-689-9788",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Diabetic Relief",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kimberly a Peters DMD PC
• Kimble Care Medical Services
• Heavenly Kimes
• Kindcare Transportation LLC
• Aliyah Kindell, LPC
• Helen King-Cox
• Ayana King
• Elyssia King, PT
• Marvin Brien King
• Steven P King, DDS

• Durable Medical Equipment & Medical Supplies in Conyers, GA
• Providers in Conyers, GA by specialty
• Durable Medical Equipment & Medical Supplies in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2018; 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.