SHONDA KING


Address: 150 Butler St Ste D5-d7, Midway, GA 31320-4575

SHONDA KING (NPI# 1255808515) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1255808515
Entity Type Individual
Full Name SHONDA KING
Credential TRICHOLOGY
Practice Address 150 Butler St Ste D5-d7
Midway
GA 31320-4575
Mailing Address Po Box 641
Midway
GA 31320-0641
Mailing Telephone 9124632883
Enumeration Date 2018-10-25
Last Update Date 2018-10-25
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261Q00000X Clinic/Center GA Ambulatory Health Care Facilities

Provider Secondary Practice Location

Address Telephone Number Fax Number
150 Butler St Ste D-5d7, Midway, GA 313204575 9124632883

Office Location

Street Address 150 BUTLER ST STE D5-D7
City MIDWAY
State GA
Zip Code 31320-4575

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
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1043437502 Noel C. Luis-smith Physical Therapist Us Highway 17 North, Woodlands Health Care LLC, Midway, GA 31320 2007-04-19
1245392224 Coastal Drug Company LLC Pharmacy 204 Butler St, Midway, GA 31320 2006-12-15
1285643320 Betty Jane Long Pharmacist 204 Butler Ave, Midway, GA 31320 2006-08-07
1255302733 Woodland Health Care LLC Skilled Nursing Facility 652 N Coastal Hwy 17, Midway, GA 31320 2006-01-31
1811986003 Traiana Daciana Pacurar Internal Medicine 586 Islands Highway, Midway, GA 31320 2005-10-19
1003391459 Liberty Orthopaedic Associates Orthopaedic Surgery 586 Islands Highway, Midway, GA 31320 2018-10-02
1093214041 Hospital Authority of Liberty County General Practice 586 Islands Highway, Midway, GA 31320 2018-02-06
1124144068 Coastal Discount Pharmacy Durable Medical Equipment & Medical Supplies 204 Butler St, Midway, GA 31320 2007-03-22
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Taxonomy Information

Taxonomy Code 261Q00000X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center

Taxonomy Definition

A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

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1558981985 Elite Mens' Health, LLC Clinic/Center 3361 Nottinghill Ln, Valdosta, GA 31605-5874 2020-04-27
1447886320 Momentum Rehab & Therapy Clinic/Center 5349 Snapfinger Woods Dr, Decatur, GA 30035-4028 2020-03-23
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Competitor

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City MIDWAY
Zip Code 31320

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Dataset Information

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.

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