KELLY KING (NPI# 1063049062) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063049062 |
| Entity Type | Individual |
| Full Name | KELLY KING |
| Credential | MD |
| Practice Address |
272 Congress St Portland ME 04101-3637 |
| Mailing Address |
4 Wendeller St Apt 2 Boston MA 02127-3532 |
| Practice Telephone | 2078742466 |
| Enumeration Date | 2020-03-27 |
| Last Update Date | 2020-03-27 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992362305 | Kelly Knepper King | Physician Assistant | 1490 Williamsboro St, Oxford, NC 27565-3498 | 2019-05-21 |
| 1023302718 | Kelly King | Physical Therapy Assistant | 2116 Sweet Gum Dr, Jonesboro, AR 72401-3603 | 2011-05-31 |
| 1801122403 | Kelly B King | Physical Therapist | 406 Cook Ct, Hopkinsville, KY 42240-8714 | 2009-11-02 |
| 1235327883 | Kelly Marie King | Physician Assistant | 13013 Sw Caddy Pl, Tigard, OR 97223-2892 | 2007-10-09 |
| 1558469106 | Kelly King | Internal Medicine | 751 Horizon Ct, Suite 202, Grand Junction, CO 81506-8733 | 2006-09-20 |
| 1699709204 | Kelly L King | Physical Therapist | 309 Highway 641 N, Camden, TN 38320-3011 | 2006-07-10 |
| 1114998606 | Kelly Ennix King | Internal Medicine | 6901 Simmons Loop, 4th Floor, Riverview, FL 33578-9498 | 2006-02-01 |
| 1659355410 | Kelly Ann King | Internal Medicine | 1835 Oddie Blvd, Sparks, NV 89431-3559 | 2005-12-05 |
| 1811527823 | Kelly King | Behavioral Analyst | 1000 Plantation Rd Ste D, Thibodaux, LA 70301-4264 | 2020-01-17 |
| 1154981496 | Kelly King | Nurse Practitioner | 35 Memorial Dr, Pinehurst, NC 28374-8708 | 2019-06-18 |
| Street Address |
272 CONGRESS ST |
| City | PORTLAND |
| State | ME |
| Zip Code | 04101-3637 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396739520 | William W Dexter | Family Medicine | 272 Congress St, Portland, ME 04102 | 2005-09-02 |
| 1841827003 | Samuel Poulin | Student in an Organized Health Care Education/Training Program | 272 Congress St, Portland, ME 04101-3637 | 2020-03-26 |
| 1275160442 | Kathryn Anne Stefos | Student in an Organized Health Care Education/Training Program | 272 Congress St, Portland, ME 04101-3637 | 2020-03-26 |
| 1841827169 | George Eyerer | Student in an Organized Health Care Education/Training Program | 272 Congress St, Portland, ME 04101-3637 | 2020-03-25 |
| 1952754947 | Lindsey Clement | Nurse Practitioner | 272 Congress St, Portland, ME 04101-3637 | 2016-07-14 |
| 1467815274 | Marc Daniel Kimball | Student in an Organized Health Care Education/Training Program | 272 Congress St, Portland, ME 04101-3637 | 2016-03-30 |
| 1598153348 | Lisa Zummach | Social Worker | 272 Congress St, Portland, ME 04101-3637 | 2015-01-02 |
| 1609298447 | Chloe Farrell | Nurse Practitioner | 272 Congress St, Portland, ME 04101-3637 | 2014-01-14 |
| 1659616159 | Amy E Hinshaw | Nurse Practitioner | 272 Congress St, Portland, ME 04101-3637 | 2012-12-10 |
| 1568758852 | Nicole C Guite | Physical Therapist | 272 Congress St, Portland, ME 04101-3637 | 2011-06-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306450655 | Jocylin Egan | Nurse Practitioner | 442 Congress Street, 2nd Floor, Portland, ME 04101 | 2020-09-03 |
| 1255963559 | Portcity Home Healthcare LLC | In Home Supportive Care | 525 Forest Avenue, Suite 8, Portland, ME 04101 | 2020-02-05 |
| 1578101929 | Mohamed Hassan Mohamed | Student in an Organized Health Care Education/Training Program | 75 Lancaster St Ste 218a, Portland, ME 04101 | 2019-12-17 |
| 1841855301 | Portland Opioid Health Home | Counselor | 48 Free St., Mezzanine Level, Portland, ME 04101 | 2019-05-09 |
| 1093379224 | Alexandra Strawbridge Maurer | Acupuncturist | 50 A Cove Street, Portland, ME 04101 | 2019-04-23 |
| 1245719541 | Scott J Whited | Nurse Practitioner | 216 Vaughan St., Mcgeachy Hall, Portland, ME 04101 | 2018-08-08 |
| 1144733064 | Alixandria Elaine Marie Winchell | Massage Therapist | One City Center, Portland, ME 04101 | 2017-11-14 |
| 1417473638 | Rachel S Schwaner | Occupational Therapist | 78 Danforth Street, Apartment 6, Portland, ME 04101 | 2017-08-18 |
| 1023538154 | Derina Boothroyd | Audiologist-Hearing Aid Fitter | 985 Forest Ave., Portland, ME 04101 | 2017-06-20 |
| 1881123297 | Mark Mccullough | Social Worker | 57 Exchange Street, Suite 403, Portland, ME 04101 | 2017-06-08 |
| Find all providers in zip 04101 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215536602 | Dario J Lapoma | Student in an Organized Health Care Education/Training Program | 1305 Se Birch St, Portland, OR 97214-5335 | 2020-10-18 |
| 1740888155 | Charles Samuel Goldfoot | Student in an Organized Health Care Education/Training Program | 1650 Nw 13th Ave Apt 109, Portland, OR 97209-3694 | 2020-10-16 |
| 1396343992 | Shelby Taylor Bowerly | Student in an Organized Health Care Education/Training Program | 4522 Ne Ainsworth St, Portland, OR 97218-1322 | 2020-10-15 |
| 1821696816 | Nancy Sierra Ferrer | Student in an Organized Health Care Education/Training Program | 3181 Sw Sam Jackson Park Rd # Or97239, Portland, OR 97239-3011 | 2020-10-13 |
| 1437757663 | David Gallacher | Student in an Organized Health Care Education/Training Program | 3303 S Bond Ave # 1, Portland, OR 97239-4501 | 2020-10-10 |
| 1366049777 | Carolyn Evans | Student in an Organized Health Care Education/Training Program | 80 Ne 14th Ave Apt 314, Portland, OR 97232-3568 | 2020-10-08 |
| 1669081659 | Amy Hill | Student in an Organized Health Care Education/Training Program | 3931 N Juneau St Apt 7, Portland, OR 97217-7419 | 2020-07-27 |
| 1558979468 | Elise Caitlin Esposito | Student in an Organized Health Care Education/Training Program | 3710 Sw U.S. Veterans Hospital Road, Dental Service P-3 Dent, Attn: Elise Esposito, Portland, OR 97239 | 2020-07-16 |
| 1750908844 | Will Cowan | Student in an Organized Health Care Education/Training Program | 455 Sw Us Veterans Hospital Road., Portland, OR 97239 | 2020-07-06 |
| 1558986364 | Haley Bosco Doyle | Student in an Organized Health Care Education/Training Program | 3587 Se Grant St, Portland, OR 97214-5829 | 2020-06-08 |
| Find all providers in PORTLAND | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.