Active NPI
Robert Allen King II, PSYD
- Clinical Psychologist
- Springfield, MO
National Provider Identifier
1992729016
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 2004033841
- Practice address
- 1312 E Lark St
Springfield, MO 65804-7351 - Phone
- (417) 820-3707
- Fax
- (417) 820-7954
- NPI assigned
- Jul 26, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 2004033841 | MO | Primary |
Addresses
Primary practice location
1312 E Lark St
Springfield, MO 65804-7351
Mailing address
PO Box 2580
Springfield, MO 65801-2580
Phone (417) 829-4620
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 431560263 | Other | MO | TRICARE |
| P01037218 | Other | MO | RR MCR |
| 499272706 | Medicaid | MO | |
| 1992729016 | Medicaid | MO |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2004033841 | MO | MD | Clinical Psychologist |
| 9463 | AZ | MD | Veterinarian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Forest Institute of Professional Psychology | Clinical | Past | Accepting new patients |
Interoperability endpoints
- rking214305@directb.mercy.net
Organizations & group practices 1
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.
-
- Clinical Psychologist
- Springfield, MO
- NPI 1235184243
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153872000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1341273600000",
"number": "1992729016",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2580",
"city": "SPRINGFIELD",
"state": "MO",
"postal_code": "658012580",
"telephone_number": "417-829-4620",
"fax_number": "417-829-4316"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1312 E LARK ST",
"city": "SPRINGFIELD",
"state": "MO",
"postal_code": "658047351",
"telephone_number": "417-820-3707",
"fax_number": "417-820-7954"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KING",
"first_name": "ROBERT",
"middle_name": "ALLEN",
"name_prefix": "Dr.",
"name_suffix": "II",
"credential": "PSYD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-26",
"last_updated": "2012-07-03",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MO",
"license": "2004033841",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRICARE",
"identifier": "431560263",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MCR",
"identifier": "P01037218",
"state": "MO"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "499272706",
"state": "MO"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1992729016",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Springfield, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.