Individual provider Active NPI

Tyler Anderson Clark King, MD

  • Hospitalist Physician
  • Little Rock, AR
National Provider Identifier
1811287857
Registry record updated May 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
E-8548 Issued in AR
Practice address
2 St Vincent Circle
Little Rock, AR 72205-2936
Phone
(501) 552-4677
Fax
(501) 552-4555
NPI assigned
Apr 11, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X E-8548 AR Primary

Addresses

Primary practice location

2 St Vincent Circle
Little Rock, AR 72205-2936

Mailing address

PO Box 23410
Little Rock, AR 72221-3410
Phone (501) 224-1690

Other identifiers 1

IdentifierTypeStateIssuer
204637001MedicaidAR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140731002407 AR Practitioner - Internal Medicine 1355567066 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Arkansas College of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
St Vincent Medical GroupGroup PAC ID 5698758803, 237 clinicians

Practice addresses (Care Compare)

2 Saint Vincent Cir
Little Rock, AR 72205-5423
Phone (501) 552-4666

7709 Hwy 107
Sherwood, AR 72120-4661
Phone (501) 552-7269

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
E-8548ARMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Vincent Medical Group CurrentSince Apr 1, 2016 Accepting new patients
St Vincent Physician Clinics LLC Past Accepting new patients

Locations

16221 Saint Vincent Way
Little Rock, AR 72223
Phone (501) 221-0888

2 Saint Vincent Cir
Little Rock, AR 72205
Phone (501) 552-2680

4 Hospital Dr
Morrilton, AR 72110
Phone (501) 977-2300

5125 Northshore Dr
North Little Rock, AR 72118

Organizations & group practices 3

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.

Hospital & facility affiliations 6

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": "1302480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684368000000",
    "number": "1811287857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 23410",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722213410",
            "telephone_number": "501-224-1690",
            "fax_number": "501-224-1927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 ST VINCENT CIRCLE",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722052936",
            "telephone_number": "501-552-4677",
            "fax_number": "501-552-4555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KING",
        "first_name": "TYLER",
        "middle_name": "ANDERSON CLARK",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-04-11",
        "last_updated": "2023-05-18",
        "certification_date": "2023-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "AR",
            "license": "E-8548",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "204637001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

Verify at the official NPI Registry.