Individual provider Active NPI

Lindsey Nicole King, MD

  • Pediatrics Physician
  • Altus, OK
National Provider Identifier
1902164916
Registry record updated Sep 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
29264 Issued in OK
Practice address
101 S Park LN
Altus, OK 73521-5731
Phone
(580) 379-6100
Fax
(580) 379-6109
NPI assigned
Apr 26, 2012
Last updated
Sep 6, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2022

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 29264 OK Primary

Addresses

Primary practice location

101 S Park LN
Altus, OK 73521-5731

Mailing address

101 S Park LN
Altus, OK 73521-5731
Phone (580) 379-6100

Other identifiers 1

IdentifierTypeStateIssuer
200442560AMedicaidOK

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address LindseyKing@direct.jcmh.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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
I20120816000443 OK Practitioner - Pediatric Medicine 7416103908 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
29264OKMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Jackson County Memorial Hospital Authority CurrentSince Jul 9, 2012 Accepting new patients
Jackson County Memorial Hospital Authority CurrentSince Jul 9, 2012 Accepting new patients
Jackson County Memorial Hosp Phcy Past Accepting new patients

Locations

101 S Park Ln
Altus, OK 73521
Phone (580) 379-6100

205 S Park Ln
Ste 210
Altus, OK 73521
Phone (580) 379-6650

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1335398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662422400000",
    "number": "1902164916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 S PARK LN",
            "city": "ALTUS",
            "state": "OK",
            "postal_code": "735215731",
            "telephone_number": "580-379-6100",
            "fax_number": "580-379-6109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 S PARK LN",
            "city": "ALTUS",
            "state": "OK",
            "postal_code": "735215731",
            "telephone_number": "580-379-6100",
            "fax_number": "580-379-6109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KING",
        "first_name": "LINDSEY",
        "middle_name": "NICOLE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-26",
        "last_updated": "2022-09-06",
        "certification_date": "2022-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OK",
            "license": "29264",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200442560A",
            "state": "OK"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "LindseyKing@direct.jcmh.com",
            "affiliation": "N",
            "address_1": "101 S Park Ln",
            "city": "Altus",
            "state": "OK",
            "country_code": "US",
            "postal_code": "735215731",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Altus, OK

Sources for this page

Verify at the official NPI Registry.