CARROLL J. KING (NPI# 1487753380) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487753380 |
| Entity Type | Individual |
| Full Name | CARROLL J. KING |
| Credential | M.D., J.D. |
| Practice Address |
404 Keene St Columbia MO 65201-6626 |
| Mailing Address |
Po Box 7687 Columbia MO 65205-7687 |
| Practice Telephone | 5732194270 |
| Practice Fax Number | 5732194279 |
| Mailing Telephone | 5732194270 |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2011-10-12 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208000000X | Pediatrics | 40586 | TX | Allopathic & Osteopathic Physicians |
| Y | 2080P0203X |
Pediatrics Specialization: Pediatric Critical Care Medicine |
1033 | MO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 169404401 | 05 |
| Street Address |
404 KEENE ST |
| City | COLUMBIA |
| State | MO |
| Zip Code | 65201-6626 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124012356 | Columbia Regional Hospital - Psychiatric Unit | Psychiatric Unit | 404 Keene St, Columbia, MO 65201-6626 | 2005-09-02 |
| 1609027044 | Matthew Scott Frey | Emergency Medicine | 404 Keene St, Columbia, MO 65201-6626 | 2008-10-03 |
| 1427258953 | Curators of The University of Missouri | Rehabilitation Unit | 404 Keene St, Columbia, MO 65201-6626 | 2007-07-23 |
| 1306045950 | Curators of The University of Missouri | General Acute Care Hospital | 404 Keene St, Columbia, MO 65201-6626 | 2007-07-13 |
| 1265599823 | Jay L Faurot IIi | Anesthesiology | 404 Keene St, Columbia, MO 65201 | 2007-01-03 |
| 1164585220 | Shauna Denise Hess | Nurse Practitioner | 404 Keene St, Columbia, MO 65201-6626 | 2006-12-19 |
| 1003907874 | Daniela Cristina Bichianu | Pediatrics | 404 Keene St, Columbia, MO 65212-0001 | 2006-09-27 |
| 1568564607 | Sarah Beth Younger | Pediatrics | 404 Keene St, Columbia, MO 65201-6626 | 2006-09-01 |
| 1851493753 | Kristin Lynette Koehn | Pediatrics | 404 Keene St, Columbia, MO 65201-6626 | 2006-09-01 |
| 1659380186 | Ruanne M Stamps | Emergency Medicine | 404 Keene St, Columbia, MO 65201-6626 | 2006-08-05 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134688534 | Thomas Havey | Specialist/Technologist | 600 E Stadium Boulevard, Columbia, MO 65201 | 2019-03-15 |
| 1881176121 | Darrea L Green | Nurse Practitioner | 3700 Interstate 70 Dr Se, Columbia, MO 65201 | 2018-09-04 |
| 1073092383 | Andrea L. Lingenfelter | Registered Nurse | 1605 East Broadway, Ste. 100, Columbia, MO 65201 | 2018-08-08 |
| 1144724238 | Angela Marie Richmond | Internal Medicine | 1 Hospital Dr Rm Ma423, Columbia, MO 65201 | 2018-03-22 |
| 1770092892 | Palmer's Home Care, LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 701 Hillsdale Road, Columbia, MO 65201 | 2017-09-20 |
| 1205358710 | Mitchell E Swee | Specialist/Technologist | 600 East Stadium Blvd, Columbia, MO 65201 | 2017-07-17 |
| 1659815470 | Colleen Jockin | Specialist | 100 Matc, Columbia, MO 65201 | 2016-12-13 |
| 1720535305 | Hannah Garrad | Dietitian, Registered | Columbia 3, 25 Conley Road, Columbia, MO 65201 | 2016-09-01 |
| 1043662570 | Restoration Chiropractic LLC | Chiropractor | 1413 Grindstone Plaza Drive, Columbia, MO 65201 | 2016-07-08 |
| 1306298930 | Taylor John Sirois | Chiropractor | 1413 Grindstone Plaza Dr., Columbia, MO 65201 | 2016-07-07 |
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| Taxonomy Code | 2080P0203X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Critical Care Medicine |
| A pediatrician expert in advanced life support for children from the term or near-term neonate to the adolescent. This competence extends to the critical care management of life-threatening organ system failure from any cause in both medical and surgical patients and to the support of vital physiological functions. This specialist may have administrative responsibilities for intensive care units and also facilitates patient care among other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition changed, source added] Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. ACGME Accredited Residency Program Requirements: 2 years of training with 3 years Pediatrics plus 1 year Pediatric Critical Care for certification for a total of 6 years. ABMS Approved Subspecialty Certificate (Pediatrics) |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740361930 | Michael Dennis Dallman | Pediatrics | 9 Richland Medical Park Dr Ste 530, Columbia, SC 29203-6870 | 2006-10-17 |
| 1093795353 | Robert D Hubbird | Pediatrics | 3 Medical Park Rd, 110, Columbia, SC 29203-6873 | 2006-01-20 |
| 1477809523 | Salim A S Aljabari | Pediatrics | 404 N Keene St, Columbia, MO 65201-6626 | 2012-07-26 |
| 1194743856 | Palmetto Health | Pediatrics | 9 Medical Park, Suite 530, Columbia, SC 29203-6859 | 2006-07-18 |
| 1710932678 | Patricia C Wankum | Pediatrics | 404 N Keene St, Columbia, MO 65201-6626 | 2006-05-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558329896 | Patricia Webster | Pediatrics | 8124 Nw Lakeview Dr, Parkville, MO 64152-4373 | 2006-05-03 |
| 1174183289 | Katelyn Moring | Pediatrics | 1 Childrens Pl, Saint Louis, MO 63110-1002 | 2019-06-20 |
| 1730610155 | Jose Emilio Morales Moreno | Pediatrics | 1465 S Grand Blvd Rm 2717, Ssm Health Cardinal Glennon Children's Hospital, Saint Louis, MO 63104-1003 | 2017-03-27 |
| 1114472115 | Ahmad Tariq Hamed | Pediatrics | 1 Childrens Pl Cb 8116, Saint Louis, MO 63110-1002 | 2016-08-18 |
| 1396144259 | Danyal Thaver | Pediatrics | 1235 E Cherokee St, Springfield, MO 65804-2203 | 2014-08-17 |
| 1548601586 | Karl M. Huebner | Pediatrics | 1 Childrens Pl, 3s34, Saint Louis, MO 63110-1002 | 2013-07-06 |
| 1174966055 | Stephen Pfeiffer | Pediatrics | 2401 Gillham Rd, Kansas City, MO 64108-4619 | 2013-04-10 |
| 1982959433 | Anya Jennifer Freedman | Pediatrics | 1465 S Grand Blvd, St. Louis, MO 63104-1003 | 2012-07-20 |
| 1992070189 | Sarah Devlin Brunner | Pediatrics | 2401 Gillham Rd, Kansas City, MO 64108-4619 | 2012-03-20 |
| 1134417389 | Reinis Balmaks | Pediatrics | 1 Childrens Pl, Cb 8116 Nwt 8, Saint Louis, MO 63110-1002 | 2011-07-20 |
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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.