Organization Active NPI

David R. King, O.D., Inc.

  • Optometrist
  • Selma, CA
National Provider Identifier
1962508945
Registry record updated Jan 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
10350TPL Issued in CA
Legal business name
DAVID R. KING, O.D., INC.
Practice address
2020 High St
Ste I
Selma, CA 93662-3518
Phone
(559) 896-3937
Fax
(559) 896-3090
NPI assigned
Sep 16, 2006
Last updated
Jan 23, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2015

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

Authorized official

Name
David R King, O.D.NPI 1720071517
Title
Owner
Phone
(559) 896-3937

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 10350TPL CA Primary

Addresses

Primary practice location

2020 High St
Ste I
Selma, CA 93662-3518

Mailing address

2020 High St
Ste I
Selma, CA 93662-3518
Phone (559) 896-3937

Other identifiers 1

IdentifierTypeStateIssuer
SD0103500MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20061213000585 CA Part B Supplier - Clinic/Group Practice 7911906268 Receives reassigned benefits from 1 practitioner
Practice locations: Selma, CA

National Provider Directory

National Provider Directory

Locations

2020 High St
Ste I
Selma, CA 93662
Phone 55988963937

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1158364800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1421971200000",
    "number": "1962508945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2020 HIGH ST",
            "address_2": "STE I",
            "city": "SELMA",
            "state": "CA",
            "postal_code": "936623518",
            "telephone_number": "559-896-3937",
            "fax_number": "559-896-3090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 HIGH ST",
            "address_2": "STE I",
            "city": "SELMA",
            "state": "CA",
            "postal_code": "936623518",
            "telephone_number": "559-896-3937",
            "fax_number": "559-896-3090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID R. KING, O.D., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-16",
        "last_updated": "2015-01-23",
        "status": "A",
        "authorized_official_last_name": "KING",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "559-896-3937",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "10350TPL",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0103500",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Selma, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.