Individual provider Active NPI

Shanthi S Thomas King, MD

  • Pediatrics Physician
  • Columbia, MD
National Provider Identifier
1891724381
Registry record updated Jun 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
D0062930 Issued in MD
Practice address
6350 Stevens Forest Rd Ste 103
Columbia, MD 21046-3255
Phone
(443) 259-3770
NPI assigned
Jun 30, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X D0062930 MD Primary

Addresses

Primary practice location

6350 Stevens Forest Rd Ste 103
Columbia, MD 21046-3255

Mailing address

3100 Wyman Park Dr
Baltimore, MD 21211-2803

Other identifiers 1

IdentifierTypeStateIssuer
408936700MedicaidMD

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepiceast.kp.org:14430/Interconnect-prodgam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq Health Information Exchange (HIE) Permanente Medical Group

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20051026000452 MD Practitioner - Pediatric MedicinePractitioner - Emergency Medicine 0244257525 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0062930MDMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc Current Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Jul 8, 2024 Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Jul 8, 2024 Accepting new patients
Johns Hopkins Community Physicians, Inc Pediatrics Current Accepting new patients
Johns Hopkins Community Physicians, Inc CurrentSince Dec 10, 2011 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

5255 Loughboro Rd NW
Washington, DC 20016
Phone (202) 243-2280

3100 Wyman Park Dr
Baltimore, MD 21211
Phone (410) 338-3000

1000 E Eager St
Baltimore, MD 21202
Phone (410) 522-9800

6350 Stevens Forest Rd
Ste 103
Columbia, MD 21046
Phone (443) 259-3770

7070 Samuel Morse Dr
Columbia, MD 21046
Phone (410) 309-4600

2101 E Jefferson St
#4E
Rockville, MD 20852

4224 Altamont PL Ste 201
Ste 201
White Plains, MD 20695
Phone (240) 607-1500

Interoperability endpoints

  • Direct secure messaging: sthomasking1145514@direct.umm.edu

Organizations & group practices 6

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": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719273600000",
    "number": "1891724381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3100 WYMAN PARK DR",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212112803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6350 STEVENS FOREST RD STE 103",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210463255",
            "telephone_number": "443-259-3770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS KING",
        "first_name": "SHANTHI",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-30",
        "last_updated": "2024-06-25",
        "certification_date": "2024-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MD",
            "license": "D0062930",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "408936700",
            "state": "MD"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodgam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "2400 Mount Zion Pkwy",
            "city": "Jonesboro",
            "state": "GA",
            "country_code": "US",
            "postal_code": "302362500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Columbia, MD

Sources for this page

Verify at the official NPI Registry.