Individual provider Active NPI

Charles Richard King III, MD

  • Obstetrics & Gynecology Physician
  • Gainesville, FL
National Provider Identifier
1851360127
Registry record updated Mar 22, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
ME21794 Issued in FL
Practice address
4343 W Newberry Rd
Ste 16
Gainesville, FL 32607-2817
Phone
(352) 333-0334
Fax
(352) 333-0337
NPI assigned
Mar 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X ME21794 FL Primary

Addresses

Primary practice location

4343 W Newberry Rd
Ste 16
Gainesville, FL 32607-2817

Mailing address

4881 NW 8TH Ave
Suite 2
Gainesville, FL 32605-4582
Phone (352) 373-6338

Other identifiers 2

IdentifierTypeStateIssuer
ME 21794OtherFLMEDICAL LICENSE
271864200MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1142553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332374400000",
    "number": "1851360127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4881 NW 8TH AVE",
            "address_2": "SUITE 2",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326054582",
            "telephone_number": "352-373-6338",
            "fax_number": "352-373-6144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4343 W NEWBERRY RD",
            "address_2": "STE 16",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326072817",
            "telephone_number": "352-333-0334",
            "fax_number": "352-333-0337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KING",
        "first_name": "CHARLES",
        "middle_name": "RICHARD",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-17",
        "last_updated": "2012-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "FL",
            "license": "ME21794",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "ME 21794",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "271864200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2012; 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.