Individual provider Active NPI

Katelyn King, MD

  • Emergency Medicine Physician
  • Orlando, FL
National Provider Identifier
1922678507
Registry record updated Jul 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
ME166478 Issued in FL
Practice address
3090 Caruso CT
Orlando, FL 32806-8564
Phone
(321) 841-5236
NPI assigned
Jun 28, 2021
Last updated
Jul 3, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X TRN33856 FL
Emergency Medicine Physician 207P00000X ME166478 FL Primary

Addresses

Primary practice location

3090 Caruso CT
Orlando, FL 32806-8564

Mailing address

3090 Caruso CT
Orlando, FL 32806-8564
Phone (321) 841-5236

Other practice location 1

86 W Underwood St Ste 200
Orlando, FL 32806-1110
Phone (407) 841-5133

Other identifiers 2

IdentifierTypeStateIssuer
TRN33856OtherFLTRAINING LICENSE
ME166478OtherFLMEDICAL LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20240729001583 FL Practitioner - Emergency Medicine 2668918491 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Western Michigan Un Homer Stryker School of Med, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency Physicians of Central Florida LLPGroup PAC ID 1850296567, 132 clinicians

Practice addresses (Care Compare)

29 W Sturtevant St
Orlando, FL 32806
Phone (321) 841-5210

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
TRN33856FLMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Physicians of Central Florida LLP Emergency Medicine CurrentSince Sep 2, 2024 Accepting new patients
Psynergy Health Med PLLC PastSince Jul 7, 2024 Accepting new patients

Locations

1900 Don Wickham Dr
Clermont, FL 34711
Phone (352) 536-8761

555 W State Road 434
Longwood, FL 32750
Phone (407) 767-1200

86 Underwood St
Ste 200
Orlando, FL 32806
Phone (407) 237-6329

9400 Turkey Lake Rd
Orlando, FL 32819
Phone (321) 843-5500

Organizations & group practices 2

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.

Hospital & facility affiliations 1

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": "1624838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719964800000",
    "number": "1922678507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3090 CARUSO CT",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328068564",
            "telephone_number": "321-841-5236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3090 CARUSO CT",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328068564",
            "telephone_number": "321-841-5236"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "86 W Underwood St Ste 200",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328061110",
            "country_code": "US",
            "telephone_number": "407-841-5133",
            "fax_number": "407-237-6313",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KING",
        "first_name": "KATELYN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-28",
        "last_updated": "2024-07-03",
        "certification_date": "2024-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "FL",
            "license": "TRN33856",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "ME166478",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRAINING LICENSE",
            "identifier": "TRN33856",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "ME166478",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.