NPIMap

Organization Active NPI

King Medical Care, Inc.

  • Specialist
  • Bloomsburg, PA
National Provider Identifier
1942335237
Registry record updated Jul 20, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
MD430581 Issued in PA
Legal business name
KING MEDICAL CARE, INC.
Practice address
3151 Columbia Blvd
Suite 100
Bloomsburg, PA 17815-8889
Phone
(570) 784-0500
Fax
(570) 784-9563
NPI assigned
Feb 23, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2007

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

Authorized official

Name
Mr. Doyle Wayne Averett
Title
Office Manager
Phone
(570) 784-0500

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X MD430581 PA Primary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X MD430599 PA

Addresses

Primary practice location

3151 Columbia Blvd
Suite 100
Bloomsburg, PA 17815-8889

Mailing address

3151 Columbia Blvd
Suite 100
Bloomsburg, PA 17815-8889
Phone (570) 784-0500

Other identifiers 2

IdentifierTypeStateIssuer
1841364890OtherNPI JENNIFER SEIDENBERG
1114960432OtherNPI PETER SEIDENBERG

National Provider Directory

National Provider Directory

Locations

3151 Columbia Blvd
Ste 100
Bloomsburg, PA 17815
Phone (570) 784-0500

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1172188800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184889600000",
    "number": "1942335237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3151 COLUMBIA BLVD",
            "address_2": "SUITE 100",
            "city": "BLOOMSBURG",
            "state": "PA",
            "postal_code": "178158889",
            "telephone_number": "570-784-0500",
            "fax_number": "570-784-9563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3151 COLUMBIA BLVD",
            "address_2": "SUITE 100",
            "city": "BLOOMSBURG",
            "state": "PA",
            "postal_code": "178158889",
            "telephone_number": "570-784-0500",
            "fax_number": "570-784-9563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KING MEDICAL CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-23",
        "last_updated": "2007-07-20",
        "status": "A",
        "authorized_official_last_name": "AVERETT",
        "authorized_official_first_name": "DOYLE",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "570-784-0500",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "PA",
            "license": "MD430581",
            "primary": true
        },
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "PA",
            "license": "MD430599",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI JENNIFER SEIDENBERG",
            "identifier": "1841364890",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI PETER SEIDENBERG",
            "identifier": "1114960432",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomsburg, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2007; 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.