Individual provider Active NPI

Kaleb King, MD

  • Family Medicine Physician
  • Edmond, OK
National Provider Identifier
1942829171
Registry record updated Sep 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
41812 Issued in OK
Practice address
1501 E 19TH St
Edmond, OK 73013-6618
Phone
(405) 348-6611
Fax
(405) 348-9280
NPI assigned
Apr 8, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 41812 OK Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

1501 E 19TH St
Edmond, OK 73013-6618

Mailing address

1501 E 19TH St
Edmond, OK 73013-6618
Phone (405) 348-6611

Other practice location 1

6051 U S Highway 49
Hattiesburg, MS 39401-7201
Phone (601) 288-1212

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
I20230915000681 OK Practitioner - Family Practice 1658794615 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Oklahoma College of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ou Health Partners IncGroup PAC ID 5991105876, 1,167 clinicians

Practice addresses (Care Compare)

14101 N Eastern Ave
Ou Health Physicians
Edmond, OK 73013-5859
Phone (572) 244-0202

900 NE 10TH St
Ouhp Family Medicine
Oklahoma City, OK 73104-5420
Phone (572) 244-0065

Hospital & facility affiliations

  • O U Medical Center Hospital, Oklahoma City, OK, CCN 370093
  • Mercy Hospital Oklahoma City, Inc Hospital, Oklahoma City, OK, CCN 370013

Merit-based Incentive Payment System (MIPS)

Final score
77.26 of 100Reported as group
Quality
53.73
Promoting interoperability
100
Improvement activities
40
Cost
70.48

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions13
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
41812OKMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ou Health Partners, Inc CurrentSince Aug 17, 2023 Accepting new patients
Ou Health Partners, Inc CurrentSince Aug 17, 2023 Accepting new patients
Ou Medicine Inc. Past Accepting new patients
Summit Medical Center Past Accepting new patients

Locations

1501 E 19th St
Edmond, OK 73013
Phone (405) 348-6611

14101 N Eastern Ave
Ste E
Edmond, OK 73013
Phone (405) 340-1279

900 NE 10th St
Oklahoma City, OK 73104
Phone (405) 271-2230

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1586304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694044800000",
    "number": "1942829171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 E 19TH ST",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730136618",
            "telephone_number": "405-348-6611",
            "fax_number": "405-348-9280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 E 19TH ST",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730136618",
            "telephone_number": "405-348-6611",
            "fax_number": "405-348-9280"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6051 U S Highway 49",
            "address_purpose": "LOCATION",
            "city": "Hattiesburg",
            "state": "MS",
            "postal_code": "394017201",
            "country_code": "US",
            "telephone_number": "601-288-1212",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KING",
        "first_name": "KALEB",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-08",
        "last_updated": "2023-09-07",
        "certification_date": "2023-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "41812",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edmond, OK

Sources for this page

Verify at the official NPI Registry.