Kelly Ennix King (NPI# 1114998606, PAC ID# 1052488681) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is INTERNAL MEDICINE.
| Nation Provider ID (NPI) | 1114998606 |
| PAC ID by PECOS | 1052488681 |
| Professional Enrollment ID | I20110510000342 |
| Full Name | Kelly Ennix King |
| Organization Legal Name | RURAL PHYSICIANS GROUP PC |
| Address |
300 Canal St King City CA 93930-3431 |
| Phone Number | 8313856000 |
| Gender | F |
| Medical School | UNIVERSITY OF TENNESSEE COLLEGE OF MEDICINE |
| Graduation Year | 2001 |
| Primary Specialty | INTERNAL MEDICINE |
| Group Practice PAC ID | 2062767148 |
| Number of Group Practice Members | 14 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 051325 | MENDOCINO COAST DISTRICT HOSPITAL |
| 051317 | ADVENTIST HEALTH CLEARLAKE |
| Address | Phone | Organization |
|---|---|---|
| 300 Canal St, King City, CA 93930-3431 | 8313856000 | RURAL PHYSICIANS GROUP PC |
| Organization Legal Name | RURAL PHYSICIANS GROUP PC |
| Physicians | 17 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Christina Tsao | Internal Medicine | Rural Physicians Group PC | 5189 Hospital Rd, Mariposa, CA 95338-9524 |
| Walter L Wynne | Internal Medicine | Rural Physicians Group PC | 1420 W H St, Oakdale, CA 95361-3557 |
| Jeremiah W Cheng | Internal Medicine | Rural Physicians Group PC | 700 River Dr, Fort Bragg, CA 95437-5403 |
| David J Gonzales | Family Medicine | Rural Physicians Group PC | 15630 18th Ave, Clearlake, CA 95422-9336 |
| Adam Jacob Colton | Family Medicine | Rural Physicians Group PC | 300 Canal St, King City, CA 93930-3431 |
| Ngocthuy N Tran | Internal Medicine | Rural Physicians Group PC | 5189 Hospital Rd, Mariposa, CA 95338-9524 |
| Nguyen Pham | Internal Medicine | Rural Physicians Group PC | 300 Canal St, King City, CA 93930-3431 |
| Faraaz Osmani | Internal Medicine | Rural Physicians Group PC | 300 Canal St, King City, CA 93930-3431 |
| Hussain A Gilani | Nephrology | Rural Physicians Group PC | 1375 University St, Healdsburg, CA 95448-3382 |
| William A Miller | Internal Medicine | Rural Physicians Group PC | 700 River Dr, Fort Bragg, CA 95437-5403 |
| Street Address |
300 CANAL ST |
| City | KING CITY |
| State | CA |
| Zip | 93930-3431 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Sean H Oldroyd | Emergency Medicine | Cep America - California | 300 Canal St, King City, CA 93930-3431 |
| Joshua H Tamayo-sarver | Emergency Medicine | Cep America - California | 300 Canal St, King City, CA 93930-3431 |
| Thomas W Unruh | General Surgery | Southern Monterey County Memorial Hospital | 300 Canal St, King City, CA 93930-3431 |
| Adam Jacob Colton | Family Medicine | Rural Physicians Group PC | 300 Canal St, King City, CA 93930-3431 |
| Samuel H Slishman | Emergency Medicine | Premier Emergency Physicians of California A Medical Corporation | 300 Canal St, King City, CA 93930-3431 |
| Elizabeth A Bartlett | Nurse Practitioner | Minuteclinic Diagnostic of Massachusetts, LLC | 300 Canal St, Salem, MA 01970-4558 |
| Kelley Gardner | Certified Registered Nurse Anesthetist (crna) | Southern Monterey County Memorial Hospital | 300 Canal St, King City, CA 93930-3431 |
| Nguyen Pham | Internal Medicine | Rural Physicians Group PC | 300 Canal St, King City, CA 93930-3431 |
| Faraaz Osmani | Internal Medicine | Rural Physicians Group PC | 300 Canal St, King City, CA 93930-3431 |
| James I Stubblefield | Emergency Medicine | Cep America - California | 300 Canal St, King City, CA 93930-3431 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Roberto Tongson | Internal Medicine | 212 Bassett St, King City, CA 93930-2943 | |
| David A Clark | Cardiovascular Disease (cardiology) | 220 N Vanderhurst Ave, King City, CA 93930-3123 | |
| Robert Mackin | Optometry | 406 Canal St, King City, CA 93930-3412 | |
| Sean P Murray | Diagnostic Radiology | 300 Canal St, King City, CA 93930-3431 | |
| Arian Yousefi | Hospitalist | Rural Physicians Group PC | 300 Canal St, King City, CA 93930-3431 |
| Michael William Seftchick | Emergency Medicine | Cep America - California | 300 Canal St, King City, CA 93930-3431 |
| Hilda Alejandre | Internal Medicine | Southern Monterey County Memorial Hospital | 300 Canal St, King City, CA 93930-3431 |
| Nina A Yaftali | Sports Medicine | 300 Canal St, King City, CA 93930-3431 | |
| Aljinder S Mangat | Internal Medicine | Rural Physicians Group PC | 300 Canal St, King City, CA 93930-3431 |
| Daniel J Ashby | Certified Registered Nurse Anesthetist | Southern Monterey County Memorial Hospital | 300 Canal St, King City, CA 93930-3431 |
| Find all physicians in zip 93930 | |||
| City | KING CITY |
| Zip Code | 93930 |
| Specialty | INTERNAL MEDICINE |
| City + Specialty | KING CITY + INTERNAL MEDICINE |
Please comment or provide details below to improve the information on Kelly Ennix King.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.