Phillip Lee King Jr., OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

683 Issued in MS

Practice address

11228 Hwy 63S
Lucedale, MS 39452

Phone

(601) 766-3800

Fax

(601) 947-2709

NPI assigned

Mar 21, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MS

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Southern College of Optometry, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Premier Eye Clinic , PLLCGroup PAC ID 8224068010, 3 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Premier Eye Clinic , PLLC

  • Optometrist
  • Pascagoula, MS
  • NPI 1164509675
  Medicare reassignment Care Compare group
• King Eye Associates Inc

  • Optometrist
  • Lucedale, MS
  • NPI 1487779971
  NPD (past) Authorized official
• The Eye Clinic PA

  • Eyewear Supplier
  • Gulfport, MS
  • NPI 1427002864

  Optometrist

  NPD (past)
• Sunil Gupta MD LLC

  • Ophthalmology Physician
  • Pensacola, FL
  • NPI 1588610075
  NPD (past)

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

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1780709279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3429 NORTH 5TH ST",
            "city": "OCEAN SPRINGS",
            "state": "MS",
            "postal_code": "39564",
            "telephone_number": "601-766-3800",
            "fax_number": "601-947-2709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11228 HWY 63S",
            "city": "LUCEDALE",
            "state": "MS",
            "postal_code": "39452",
            "telephone_number": "601-766-3800",
            "fax_number": "601-947-2709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KING",
        "first_name": "PHILLIP",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-21",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MS",
            "license": "683",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kesha Brown Johnson, RN,BSN
• Jones County Medical Supplies, Inc
• Keith Brown DMD, Inc.
• King Eye Associates Inc
• Dannette Newman King, OD
• Lazada Knight
• Gina I Knitter, LMSW
• Gisselle Ladnier
• Tyson Dale Lancaster, PHARM.D.
• Jillian Langley, MA

• Optometrist in Lucedale, MS
• Providers in Lucedale, MS by specialty
• Optometrist in Mississippi

• 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.
• 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.