Active NPI
Madelyn B King, NP
- Family Nurse Practitioner
- Columbus, MS
National Provider Identifier
1861420978
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 862819
- Practice address
- 2323 5TH St N
Columbus, MS 39705-2213 - Phone
- (662) 368-1169
- Fax
- (662) 570-1492
- NPI assigned
- Jun 29, 2006
- Last updated
- Aug 28, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 862819 | MS | Primary |
Addresses
Primary practice location
2323 5TH St N
Columbus, MS 39705-2213
Mailing address
2323 5TH St N
Columbus, MS 39705-2213
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 03659286 | Medicaid | MS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MS
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 862819 | MS | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University Internal Medicine Assoc LLP | Past | Accepting new patients | |
| Cardiac Imaging Inc | Past | Accepting new patients |
Organizations & group practices 4
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151539200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1566950400000",
"number": "1861420978",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2323 5TH ST N",
"city": "COLUMBUS",
"state": "MS",
"postal_code": "397052213"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2323 5TH ST N",
"city": "COLUMBUS",
"state": "MS",
"postal_code": "397052213",
"telephone_number": "662-368-1169",
"fax_number": "662-570-1492"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KING",
"first_name": "MADELYN",
"middle_name": "B",
"name_prefix": "Mrs.",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-29",
"last_updated": "2019-08-28",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "MS",
"license": "862819",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "03659286",
"state": "MS"
}
],
"endpoints": [],
"other_names": []
}Other providers in Columbus, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.