Jerry J King, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

770597 Issued in MT

Practice address

2831 Fort Missoula Rd
Suite 232
Missoula, MT 59804-7419

Phone

(406) 728-6101

Fax

(406) 721-3278

NPI assigned

Mar 15, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Community Medical Center Inc

  • Specialist
  • Missoula, MT
  • NPI 1548353519
  NPD (past)

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

{
    "created_epoch": "1142380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1790754463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2831 FORT MISSOULA RD",
            "address_2": "SUITE 232",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598047419",
            "telephone_number": "406-728-6101",
            "fax_number": "406-721-3278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2831 FORT MISSOULA RD",
            "address_2": "SUITE 232",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598047419",
            "telephone_number": "406-728-6101",
            "fax_number": "406-721-3278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KING",
        "first_name": "JERRY",
        "middle_name": "J",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-15",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MT",
            "license": "770597",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0023283",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dale Stubbs Kindred, RN BSN
• Hollice Emily Kindred, APRN
• King Family Behavioral Health
• Honeyrae King-Campbell, OPTICIAN
• Jennifer Lynn Dodson King, LCSW
• Jesse King, LMFT
• Kelsy King, COTA/L
• Kenadee Lucille King
• Tony W King, PHARMD
• Anthony Earl Kinney, PT, DPT

• Surgical Physician Assistant in Missoula, MT
• Providers in Missoula, MT by specialty
• Surgical Physician Assistant in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.