JERRY N KING (NPI# 1669476396) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669476396 |
| Entity Type | Individual |
| Full Name | JERRY N KING |
| Credential | M.D. |
| Practice Address |
4411 The 25 Way Ne Ste 150 Albuquerque NM 87109-5888 |
| Practice Telephone | 5053326900 |
| Practice Fax Number | 5053326921 |
| Mailing Telephone | 5053326900 |
| Mailing Fax Number | 5053326921 |
| Enumeration Date | 2005-06-10 |
| Last Update Date | 2014-03-12 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0204X |
Radiology Specialization: Vascular & Interventional Radiology |
80-52 | NM | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NM | 45138 | 05 | |
| NM | L0634 | 05 | |
| NM | 52713 | 05 | |
| NM | MEDICARE GROUP | 2258272 | 01 |
| NM | 9035 | 05 | |
| NM | MEDICARE IDTF | 600521002 | 01 |
| NM | MEDICARE IDTF | 800521126 | 01 |
| NM | MEDICARE GROUP | 700521102 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255506671 | Jerry N King | Surgery | 12731 S 83rd Ct, Palos Park, IL 60464-2026 | 2008-04-27 |
| 1346205689 | Jerry D King | Optometrist | 115 N Oak St, Eldon, MO 65026-1444 | 2006-04-19 |
| 1154465482 | Jerry Everett King | Radiology | 10180 Se Sunnyside Rd, Clackamas, OR 97015-8970 | 2007-02-19 |
| 1417020462 | Jerry Lee King | Optometrist | 103 W Loop 281, Ste 450, Longview, TX 75605-4653 | 2006-11-16 |
| 1538101845 | Jerry R King | Counselor | 12 Medical Dr, Amarillo, TX 79106-4136 | 2006-06-12 |
| 1790754463 | Jerry J King | Physician Assistant | 2831 Fort Missoula Rd, Suite 232, Missoula, MT 59804-7419 | 2006-03-15 |
| Street Address |
4411 THE 25 WAY NE STE 150 |
| City | ALBUQUERQUE |
| State | NM |
| Zip Code | 87109-5888 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851395610 | Jack A Brock | Radiology | 4411 The 25 Way Ne, Ste 150, Albuquerque, NM 87109-5888 | 2005-06-09 |
| 1063048957 | Shannon G Starr | Social Worker | 4411 The 25 Way Ne, Albuquerque, NM 87109-5857 | 2020-03-23 |
| 1720310659 | Advanced Imaging LLC | Radiology | 4411 The 25 Way Ne, Suite 150, Albuquerque, NM 87109-5857 | 2010-02-03 |
| 1649413584 | Charles Edward Lohr IIi | Radiology | 4411 The 25 Way Ne, Suite 150, Albuquerque, NM 87109-5857 | 2009-04-08 |
| 1821240201 | Lovelace Health System, Inc. | Psychologist | 4411 The 25 Way Ne, Ste. 100, Albuquerque, NM 87109-5857 | 2008-10-16 |
| 1639375397 | Christopher Nathaniel Roybal | Ophthalmology | 4411 The 25 Way Ne, Suite 325, Albuquerque, NM 87109-5857 | 2007-06-21 |
| 1184828832 | Kathleen Marie Lopez | Radiology | 4411 The 25 Way Ne, Suite 150, Albuquerque, NM 87109-5857 | 2007-06-14 |
| 1922127158 | Radiology Associates of Albuquerque | Radiology | 4411 The 25 Way Ne, Suite 150, Albuquerque, NM 87109-5857 | 2007-03-28 |
| 1558416974 | Advanced Imaging LLC | Radiology | 4411 The 25 Way Ne, Suite 150, Albuquerque, NM 87109-5857 | 2007-01-24 |
| 1669532008 | Stephen Brent Carroll | Radiology | 4411 The 25 Way Ne, Suite 150, Albuquerque, NM 87109-5857 | 2006-12-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386286367 | Mikaela Epaloose | Behavior Technician | 100 Sun Avenue N.e., Suite 650, Albuquerque, NM 87109 | 2019-10-11 |
| 1245872464 | Marsha Director | Behavior Technician | 100 Sun Avenue Ne, Ste 650, Albuquerque, NM 87109 | 2019-10-09 |
| 1720637499 | Nancy Gail Vice | Technician | 7319 Laguna Niguel Drive Ne, Albuquerque, NM 87109 | 2019-09-05 |
| 1598314411 | Chau Vu | Behavior Technician | Attn: Behavioral Health Works 100 Sun Avenue N.e., Suite 650, Albuquerque, NM 87109 | 2019-09-04 |
| 1932753498 | Noelle Nielsen | Behavior Technician | 6401 Academy Rd. Ne Apt. 189, Albuquerque, NM 87109 | 2019-08-01 |
| 1952967952 | Caridad Merkel | Obstetrics & Gynecology | 6100 Pan American Fwy Ne Suite 450, Albuquerque, NM 87109 | 2019-05-15 |
| 1043795149 | Margaret Mcconville | Physical Therapist | Lovelace Women's Hospital Outpatient Rehabilitation, 4600 Montgomery Blvd Ne, Albuquerque, NM 87109 | 2018-09-25 |
| 1922586262 | Clark Endodontics LLC | Dentist | 7520 Montgomery Blvd Ne Bldg E1, Albuquerque, NM 87109 | 2018-07-30 |
| 1447736202 | Melissa Christine Scott | Registered Nurse | Lovelace Women's Hospital, 4701 Montgomery Blvd Ne, Albuquerque, NM 87109 | 2018-07-16 |
| 1508351990 | Gianna Nicole Casarez-quintana | Dentist | 7520 Montgomery Blvd Ne Bldg E10, Albuquerque, NM 87109 | 2018-06-27 |
| Find all providers in zip 87109 | ||||
| Taxonomy Code | 2085R0204X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Vascular & Interventional Radiology |
| A radiologist who diagnoses and treats diseases by various radiologic imaging modalities. These include fluoroscopy, digital radiography, computed tomography, sonography and magnetic resonance imaging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982627238 | William Schaeffer | Radiology | Unm Dept of Radiology Msc10 5530, 1 University of New Mexico, Albuquerque, NM 87131-0001 | 2006-07-26 |
| 1598756595 | Michael Allen Gooden | Radiology | 201 Cedar St Se Ste 800, Albuquerque, NM 87106-4912 | 2005-10-31 |
| 1770587115 | Edward Poon | Radiology | 3860 Masthead St Ne, Albuquerque, NM 87109-4479 | 2005-06-13 |
| 1932736907 | City Mobile Group, LLC | Radiology | 524 Richmond Dr Se, Albuquerque, NM 87106-2328 | 2020-03-26 |
| 1811341662 | Pain Consultants & Intervention PC | Radiology | 3860 Masthead St Ne, Albuquerque, NM 87109-4479 | 2016-04-19 |
| 1174911093 | New Mexico Center for Minimally Invasive Therapies | Radiology | 4901 Lang Ave Ne, Suite 202, Albuquerque, NM 87109-4495 | 2014-12-30 |
| 1487997243 | Emily Rose Ochmanek | Radiology | Msc 10 5530, 1 University of New Mexico, Albuquerque, NM 87131-0001 | 2013-03-30 |
| 1053638981 | Ryan Craig Lebaron | Radiology | Msc10 5530, 1 University of New Mexico, Albuquerque, NM 87131-0001 | 2010-05-03 |
| 1659697720 | Paul Ryan Vantine | Radiology | 1 University of New Mexico, Albuquerque, NM 87131-0001 | 2010-04-14 |
| 1649413584 | Charles Edward Lohr IIi | Radiology | 4411 The 25 Way Ne, Suite 150, Albuquerque, NM 87109-5857 | 2009-04-08 |
| Find all providers in ALBUQUERQUE | ||||
| City | ALBUQUERQUE |
| Zip Code | 87109 |
Please comment or provide details below to improve the information on JERRY N KING.
| 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.