DR. KENNETH WILLIAM KING JR. (NPI# 1174524722) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1174524722 |
Entity Type | Individual |
Full Name | DR. KENNETH WILLIAM KING JR. |
Credential | O.D. |
Practice Address |
1480 E Lincoln Rd Idaho Falls ID 83401-2128 |
Practice Telephone | 2085258686 |
Practice Fax Number | 2085258684 |
Mailing Telephone | 2085258686 |
Mailing Fax Number | 2085258684 |
Enumeration Date | 2005-08-04 |
Last Update Date | 2013-12-20 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 152WC0802X |
Optometrist Specialization: Corneal and Contact Management |
ODP0467 | ID | Eye and Vision Services Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
DMERC | 0605250001 | 01 | |
CHAMPUS | I-902428 | 01 | |
ID | 002543100 | 05 | |
ID | BLUE SHIELD | 82052 | 01 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1376751636 | Kenneth D King | Massage Therapist | 2024 54th Ave E, Suite A, Fife, WA 98424-1901 | 2007-05-18 |
1447466842 | Kenneth Joe King | Dentist | 2815 Eastex Fwy, Houston, TX 77026-6009 | 2007-05-15 |
1811027329 | Kenneth R King | Psychiatry & Neurology | 15600 Redmond Way Ste 201, Redmond, WA 98052-3862 | 2007-03-06 |
1164587796 | Kenneth Arthur King | Dentist | 10920 River Front Pkwy, Roseman University of Health Sciences, Codm, South Jordan, UT 84095-3538 | 2006-12-26 |
1750469680 | Kenneth Brian King | Optometrist | 4501 Heritage Trace Pkwy Ste 121, Fort Worth, TX 76244 | 2006-11-01 |
1568434843 | Kenneth B King | Internal Medicine | 500 George Mcclain Drive, Benton, KY 42025 | 2006-02-02 |
1942206651 | Kenneth Raymond King | Allergy & Immunology | 2101 Executive Dr, Tower Box 56, Hampton, VA 23666-2404 | 2005-06-27 |
1568086346 | Kenneth Leroy King Sr. | Student in an Organized Health Care Education/Training Program | 1900 Silver Lake Rd Nw, New Brighton, MN 55112-1786 | 2020-06-08 |
1548738941 | Kenneth King | Physical Therapist | 5 Pequot Park Rd Ste 102, Westbrook, CT 06498-2856 | 2018-11-05 |
1386177327 | Kenneth Ron King | Podiatrist | 13030 121st Way Ne Ste 204, Kirkland, WA 98034-3008 | 2017-04-06 |
Street Address |
1480 E LINCOLN RD |
City | IDAHO FALLS |
State | ID |
Zip Code | 83401-2128 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1194174441 | Scott David Hyatt | Optometrist | 1480 E Lincoln Rd, Idaho Falls, ID 83401-2128 | 2016-06-08 |
1689015075 | Melanie Dawn Clark | Optometrist | 1480 E Lincoln Rd, Idaho Falls, ID 83401-2128 | 2013-07-12 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1407454796 | Natalie M Theriault | Acupuncturist | 864 S Holmes, Idaho Falls, ID 83401 | 2020-10-09 |
1366099293 | Idaho Recovery Center, LLC. | Counselor | 771 South Woodruff Avenue, Idaho Falls, ID 83401 | 2019-08-26 |
1851859110 | Rebecca Chidester | Counselor | 771 Parkwood St., Idaho Falls, ID 83401 | 2019-03-06 |
1467924985 | Benchmark Home Health | Registered Nurse | 2098 Gladys Dr., Idaho Falls, ID 83401 | 2018-12-21 |
1134625338 | Idaho Falls Hand Therapy Limited Partnership | Clinic/Center | 564 S Woodruff Avenue, Idaho Falls, ID 83401 | 2018-04-05 |
1992227367 | Brenda Emery | Rehabilitation Practitioner | 540 3rd Street, Idaho Falls, ID 83401 | 2017-07-07 |
1689068454 | Addiction Treatment Centers of Idaho | Community/Behavioral Health | 211 S. Woodruff Avenue, Idaho Falls, ID 83401 | 2015-03-19 |
1386986412 | Jennifer Lee Henderson | Psychologist | 111 E. 16th Street, Innovative Health Care Concepts Inc., Idaho Falls, ID 83401 | 2013-03-27 |
1487994430 | Sterling Physician Group Pllc | Clinic/Center | 740 S. Woodruff Ave, Idaho Falls, ID 83401 | 2013-02-27 |
1952638025 | Allstar Counseling Inc. | Case Management | 550 2nd Street, Suite 269, Idaho Falls, ID 83401 | 2009-11-11 |
Find all providers in zip 83401 |
Taxonomy Code | 152WC0802X |
Grouping | Eye and Vision Services Providers |
Classification | Optometrist |
Specialization | Corneal and Contact Management |
The professional activities performed by an Optometrist related to the fitting of contact lenses to an eye, ongoing evaluation of the cornea’s ability to sustain successful contact lens wear, and treatment of any external eye or corneal condition which can affect contact lens wear. |
Notes: Source: American Optometric Association [1/1/2009: added definition, added source] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1700163839 | Nicholas J Kelsey | Optometrist | 503 Broadway Ave S, Suite A, Buhl, ID 83316-1312 | 2011-11-03 |
1619185485 | Ada County Eyecare, P.C. | Optometrist | 2069 E Feldspar Ct, Boise, ID 83712-8456 | 2007-05-18 |
1285759753 | Brent Anthony Galvan | Optometrist | 8102 W Northview St, Boise, ID 83704-4406 | 2007-03-20 |
1194823930 | Deborah Ann Amato | Optometrist | 8641 W Franklin, Boise, ID 83709 | 2006-09-20 |
1821082470 | Lance F Ough | Optometrist | 350 N Milwaukee St, #2153, Boise, ID 83704-9123 | 2005-09-08 |
1447540802 | Cole Family Eye Center, Pa | Optometrist | 8102 W Northview St, Boise, ID 83704 | 2011-04-19 |
1033302161 | Rob Dee Christensen | Optometrist | 1410 Broadway Ave, Boise, ID 83706-3706 | 2007-08-22 |
1427256288 | Scott Burns Taylor | Optometrist | 1301 Main St, Suite 10, Salmon, ID 83467-4453 | 2007-07-03 |
1538388624 | Sparhawk Vision, Chtd | Optometrist | 2025 12th Ave Rd, Suite 100, Nampa, ID 83686-6459 | 2007-04-25 |
1225178593 | Douglass Eugene Hanson | Optometrist | 24 E Main St, Rexburg, ID 83440-1927 | 2007-02-07 |
Find all providers with the same taxonomy |
City | IDAHO FALLS |
Zip Code | 83401 |
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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.