Individual provider Active NPI

Adam King, PA-C

  • Physician Assistant
  • Salem, OR
National Provider Identifier
1821287608
Registry record updated Oct 17, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA01281 Issued in OR
Practice address
150 Kingwood Ave NW
Salem, OR 97304-4030
Phone
(503) 378-7526
Fax
(503) 585-4278
NPI assigned
Oct 17, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA01281 OR Primary

Addresses

Primary practice location

150 Kingwood Ave NW
Salem, OR 97304-4030

Mailing address

150 Kingwood Ave NW
Salem, OR 97304-4030
Phone (503) 378-7526

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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

Enrollment IDStateProvider typePAC IDDetails
I20071213000184 OR Practitioner - Physician Assistant 3678663796 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Oregon Health Sciences University School of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Peacehealth Networks on Demand LLCGroup PAC ID 1759731383, 197 clinicians

Practice addresses (Care Compare)

10221 SE Sunnyside Rd
Clackamas, OR 97015-9782
Phone (864) 664-3984

11355 SW Scholls Ferry Rd
Beaverton, OR 97008-7167
Phone (864) 664-3984

11956 SW Garden PL
Tigard, OR 97223-8248
Phone (503) 684-8252

1400 NE Alberta St
Portland, OR 97211-5044
Phone (864) 664-3984

2400 E Burnside St
Portland, OR 97214-1752
Phone (864) 664-3984

3060 SE Hawthorne Blvd
Portland, OR 97214-4121
Phone (864) 664-3984

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA01281ORMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Zoomcare PC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: adam.king.1@30646.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/30646/brand/1/csg/1/fhir/r4

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1192579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192579200000",
    "number": "1821287608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 KINGWOOD AVE NW",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973044030",
            "telephone_number": "503-378-7526",
            "fax_number": "503-585-4278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 KINGWOOD AVE NW",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973044030",
            "telephone_number": "503-378-7526",
            "fax_number": "503-585-4278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KING",
        "first_name": "ADAM",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-10-17",
        "last_updated": "2007-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA01281",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, OR

Sources for this page

Verify at the official NPI Registry.