NPIMap

Individual provider Active NPI

Lewis Roy King, MD

  • Family Medicine Physician
  • Gilmer, TX
National Provider Identifier
1841293487
Registry record updated Jan 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
J2129 Issued in TX
Practice address
602 Titus St
Suite 140
Gilmer, TX 75644-1700
Phone
(903) 843-2202
Fax
(903) 843-2212
NPI assigned
May 27, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X J2129 TX Primary

Addresses

Primary practice location

602 Titus St
Suite 140
Gilmer, TX 75644-1700

Mailing address

602 Titus St Ste 140
Gilmer, TX 75644-1780
Phone (903) 843-2202

Other identifiers 1

IdentifierTypeStateIssuer
138347319MedicaidTX

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090430000114 TX Practitioner - Family Practice 5193873248 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Baylor College of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Associated Clinicians of East TexasGroup PAC ID 4789957440, 106 clinicians

Practice addresses (Care Compare)

602 Titus St
Suite 140
Gilmer, TX 75644-1780
Phone (903) 843-2202

Hospital & facility affiliations

  • Onesource Home Care Inc Home health agency, Longview, TX, CCN 679138
  • Traditions Health Home health agency, Longview, TX, CCN 678338
  • Longview Regional Medical Center Hospital, Longview, TX, CCN 450702
  • Christus Good Shepherd Medical Center Hospital, Longview, TX, CCN 450032
  • Ut Health East Texas Tyler Regional Hospital Hospital, Tyler, TX, CCN 450083
  • Christus Mother Frances Hospital Hospital, Tyler, TX, CCN 450102

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
J2129TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Associated Clinicians of East Texas Family Medicine CurrentSince Sep 1, 2017 Accepting new patients
East Texas Medical Center Healthcare Associates Past Accepting new patients
Associated Clinicians of East Texas Past Accepting new patients

Locations

602 Titus St
Ste 140
Gilmer, TX 75644
Phone (903) 843-2202

805 Medical Cir
Longview, TX 75605
Phone (903) 232-8100

1009 N 4th St
Ste A
Longview, TX 75601
Phone (903) 757-3808

707 Hollybrook Dr
Ste 500
Longview, TX 75605
Phone (903) 232-8276

Interoperability endpoints

  • Direct secure messaging: lewis.king.1@23550.direct.athenahealth.com

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": "1117152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674518400000",
    "number": "1841293487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "602 TITUS ST STE 140",
            "city": "GILMER",
            "state": "TX",
            "postal_code": "756441780",
            "telephone_number": "903-843-2202",
            "fax_number": "903-843-2212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "602 TITUS ST",
            "address_2": "SUITE 140",
            "city": "GILMER",
            "state": "TX",
            "postal_code": "756441700",
            "telephone_number": "903-843-2202",
            "fax_number": "903-843-2212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KING",
        "first_name": "LEWIS",
        "middle_name": "ROY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-27",
        "last_updated": "2023-01-24",
        "certification_date": "2023-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "J2129",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "138347319",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gilmer, TX

Sources for this page

Verify at the official NPI Registry.