Kings Medical Group PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

A77882 Issued in CA

Legal business name

KINGS MEDICAL GROUP PC

Practice address

808 Vaughn St
Hanford, CA 93230

Phone

(559) 410-8404

NPI assigned

Jul 9, 2014

Organization subpart

No

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

Authorized official

Name

John R Gavini, M.D.NPI 1750328803

Title

President

Phone

(559) 410-8404

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 3

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

• John R Gavini, M.D.

  • Internal Medicine Physician
  • Hanford, CA
  • NPI 1750328803
  Medicare reassignment Care Compare group Authorized official
• Sudesh Nagavalli, MD

  • Internal Medicine Physician
  • Hanford, CA
  • NPI 1780629691
  Medicare reassignment Care Compare group NPD
• Asela Wickremasinghe, M.D.

  • Internal Medicine Physician
  • Hanford, CA
  • NPI 1164476081
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1404864000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1480896000000",
    "number": "1972919116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 N 12TH AVE",
            "address_2": "SUITE 109 #303",
            "city": "HANFORD",
            "state": "CA",
            "postal_code": "932305995",
            "telephone_number": "559-410-8404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "808 VAUGHN ST",
            "city": "HANFORD",
            "state": "CA",
            "postal_code": "93230",
            "telephone_number": "559-410-8404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KINGS MEDICAL GROUP PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-09",
        "last_updated": "2016-12-05",
        "status": "A",
        "authorized_official_last_name": "GAVINI",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "559-410-8404",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A77882",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kings Eye Center Medical Group, Inc.
• Kings Eye Center Medical Group, Inc.
• Kings Eye Center Medical Group, Inc.
• Kings Foot and Ankle Center, Inc.
• Kings Healthcare & Wellness Center LP
• Kings River Surgical Center, LLC
• Kings View
• Kings View
• Kings View
• Kings View Corporation

• Internal Medicine Physician in Hanford, CA
• Providers in Hanford, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.