Active NPI
Alan Gregory King III
- Homemaker
- Derby, CT
National Provider Identifier
1962281196
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Homemaker
- License
- 0002292
- Practice address
- 92 Olivia St Apt 1
Derby, CT 06418-1767 - Phone
- (475) 414-9454
- NPI assigned
- Sep 26, 2023
- Last updated
- Sep 26, 2023
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Homemaker | 376J00000X | 0002292 | CT | Primary |
Addresses
Primary practice location
92 Olivia St Apt 1
Derby, CT 06418-1767
Mailing address
92 Olivia St Apt 1
Derby, CT 06418-1767
Phone (475) 414-9454
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0002292 | CT | MD | Homemaker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1695686400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1695686400000",
"number": "1962281196",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "92 OLIVIA ST APT 1",
"city": "DERBY",
"state": "CT",
"postal_code": "064181767",
"telephone_number": "475-414-9454"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "92 OLIVIA ST APT 1",
"city": "DERBY",
"state": "CT",
"postal_code": "064181767",
"telephone_number": "475-414-9454"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KING III",
"first_name": "ALAN",
"middle_name": "GREGORY",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-09-26",
"last_updated": "2023-09-26",
"certification_date": "2023-09-26",
"status": "A"
},
"taxonomies": [
{
"code": "376J00000X",
"taxonomy_group": "",
"desc": "Homemaker",
"state": "CT",
"license": "0002292",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Derby, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.