JACK KING (NPI# 1649811902) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649811902 |
| Entity Type | Individual |
| Full Name | JACK KING |
| Practice Address |
2501 Rice Lake Rd Duluth MN 55811-4819 |
| Mailing Address |
810 1st St Proctor MN 55810-2705 |
| Practice Telephone | 2186256400 |
| Mailing Telephone | 2183415513 |
| Enumeration Date | 2019-10-07 |
| Last Update Date | 2019-10-07 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 235Z00000X | Speech-Language Pathologist | 7926 | MN | Speech, Language and Hearing Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811992332 | Jack Douglas King | Dentist | 1706 Davie Ave, Ste B, Statesville, NC 28677-3589 | 2005-06-21 |
| 1477916450 | Jack D King IIi | Technician, Other | 440 N Main St, Imlay City, MI 48444-1151 | 2016-03-29 |
| 1164563706 | Jack Donald King Jr. | Family Medicine | 1826 Ailor Ave, Knoxville, TN 37921-5802 | 2007-02-08 |
| 1922050780 | Jack Dennis King | Pediatrics | 3094 W Market St, Suite 103, Fairlawn, OH 44333-3626 | 2006-05-17 |
| Street Address |
2501 RICE LAKE RD |
| City | DULUTH |
| State | MN |
| Zip Code | 55811-4819 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245387372 | Chris Jensen LLC | Skilled Nursing Facility | 2501 Rice Lake Rd, Duluth, MN 55811-4819 | 2007-01-04 |
| 1316545650 | Erika Klang | Speech-Language Pathologist | 2501 Rice Lake Rd, Duluth, MN 55811-4819 | 2020-10-09 |
| 1174148308 | Bryan Douglas Johnson | Physical Therapist | 2501 Rice Lake Rd, Duluth, MN 55811-4819 | 2020-06-12 |
| 1063067999 | Ashley Weber | Speech-Language Pathologist | 2501 Rice Lake Rd, Duluth, MN 55811-4819 | 2019-08-07 |
| 1902271455 | Samuel Reindal | Physical Therapy Assistant | 2501 Rice Lake Rd, Duluth, MN 55811-4819 | 2015-12-09 |
| 1760889778 | Nichole Marie Fairbanks | Physical Therapist | 2501 Rice Lake Rd, Duluth, MN 55811-4819 | 2014-11-20 |
| 1417361890 | Amanda Pierre | Physical Therapy Assistant | 2501 Rice Lake Rd, Duluth, MN 55811-4819 | 2014-06-13 |
| 1780098301 | Anna Cochran | Occupational Therapy Assistant | 2501 Rice Lake Rd, Duluth, MN 55811-4819 | 2014-06-12 |
| 1679996540 | Charlene Schlenvogt | Physical Therapy Assistant | 2501 Rice Lake Rd, Duluth, MN 55811-4819 | 2014-01-29 |
| 1962832196 | Patrick Oltmanns | Physical Therapist | 2501 Rice Lake Rd, Duluth, MN 55811-4819 | 2013-11-25 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417515339 | Kyle Olson-merrick | Dentist | 320 W Myrtle St, Ste 100, Duluth, MN 55811 | 2019-06-05 |
| 1184288979 | Pdg, P.a. | Clinic/Center | 4891 Miller Truck Hwy., Suite 100, Hermantown, MN 55811 | 2019-04-26 |
| 1528589843 | Breanna Joy Greenly | Counselor | 4720 Burning Tree Road, Birch Tree Center, Duluth, MN 55811 | 2017-06-28 |
| 1396102398 | Debbie Christian | Registered Nurse | 4815 Burning Tree Rd Suite 100, Duluth, MN 55811 | 2016-01-21 |
| 1831556935 | Megan Marie Paris | Psychologist | 715 East Central Entrance, Duluth, MN 55811 | 2016-01-20 |
| 1740666908 | Angela Fedo | Physical Therapy Assistant | 2101 Trinity Rd, Duluth, MN 55811 | 2015-08-10 |
| 1649657479 | Kayla Stephenson | Specialist/Technologist | 5024 Morris Thomas Road, Hermantown, MN 55811 | 2015-04-30 |
| 1073918843 | Northern Lives Inc. | Assisted Living Facility | 4014 Trinity Road, Duluth, MN 55811 | 2014-10-23 |
| 1114326238 | Donald Hermanson | Specialist/Technologist | 801 Boulder Drive, Apt. 202, Duluth, MN 55811 | 2014-08-14 |
| 1679990857 | Jodie Little | Pharmacist | 801 W. Central Entrance, Shopko Pharmacy 2114, Duluth, MN 55811 | 2014-03-25 |
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| Taxonomy Code | 235Z00000X |
| Grouping | Speech, Language and Hearing Service Providers |
| Classification | Speech-Language Pathologist |
| The speech-language pathologist is the professional who engages in clinical services, prevention, advocacy, education, administration, and research in the areas of communication and swallowing across the life span from infancy through geriatrics. Speech-language pathologists address typical and atypical impairments and disorders related to communication and swallowing in the areas of speech sound production, resonance, voice, fluency, language (comprehension and expression), cognition, and feeding and swallowing. |
| Notes: "Scope of Practice in Speech-Language Pathology", American Speech-Language-Hearing Association, 2013. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497368310 | Israel Montano | Speech-Language Pathologist | 1521 N 9th Ave E, Duluth, MN 55805-1120 | 2020-08-29 |
| 1447873195 | Twt Speech Therapy LLC | Speech-Language Pathologist | 2255 Satellite Blvd Apt A303, Duluth, GA 30097-6245 | 2020-05-28 |
| 1821621889 | Ritu Walia | Speech-Language Pathologist | 1655 Centerview Dr Apt 313, Duluth, GA 30096-8918 | 2020-02-18 |
| 1104464932 | Andrea Robinson | Speech-Language Pathologist | 4500 Satellite Blvd Ste 2500, Duluth, GA 30096-5047 | 2019-12-11 |
| 1841768512 | Talitha Mylia Jeffrey | Speech-Language Pathologist | 1335 Herrington Rd Apt 3322, Duluth, GA 30096-6431 | 2018-11-10 |
| 1790209880 | Debrienne Robinson | Speech-Language Pathologist | 4500 Satellite Blvd Ste 2250, Duluth, GA 30096-5047 | 2017-07-31 |
| 1962924506 | Caryn Kaasa | Speech-Language Pathologist | 5739 Sunburst Dr, Duluth, MN 55810-9552 | 2017-07-14 |
| 1396284246 | Valarie Beth Ostrander | Speech-Language Pathologist | 407 East Second Street, Essentia Health St Mary's Medical Center, Duluth, MN 55805-1950 | 2017-02-13 |
| 1023565603 | Elyse Marilee Mccoshen | Speech-Language Pathologist | Essentia Health St Mary's Medical Center, 407 East Third Street, Duluth, MN 55805-1950 | 2016-09-01 |
| 1073964813 | Teressa Haglin | Speech-Language Pathologist | 208 W Rainbow St, Duluth, MN 55811-2006 | 2016-06-23 |
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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.