KELLY E KING (NPI# 1861408932) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861408932 |
| Entity Type | Individual |
| Full Name | KELLY E KING |
| Credential | MD |
| Practice Address |
3600 Joseph Siewick Dr Fairfax VA 22033 |
| Mailing Address |
Po Box 494 Nassau DE 19969-0494 |
| Practice Telephone | 7033913600 |
| Mailing Telephone | 3025690352 |
| Mailing Fax Number | 3026459714 |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2020-07-28 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | 0101054870 | VA | Allopathic & Osteopathic Physicians |
| N | 207PE0004X |
Emergency Medicine Specialization: Emergency Medical Services |
0101054870 | VA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | 010113261 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992362305 | Kelly Knepper King | Physician Assistant | 1490 Williamsboro St, Oxford, NC 27565-3498 | 2019-05-21 |
| 1023302718 | Kelly King | Physical Therapy Assistant | 2116 Sweet Gum Dr, Jonesboro, AR 72401-3603 | 2011-05-31 |
| 1801122403 | Kelly B King | Physical Therapist | 406 Cook Ct, Hopkinsville, KY 42240-8714 | 2009-11-02 |
| 1235327883 | Kelly Marie King | Physician Assistant | 13013 Sw Caddy Pl, Tigard, OR 97223-2892 | 2007-10-09 |
| 1558469106 | Kelly King | Internal Medicine | 751 Horizon Ct, Suite 202, Grand Junction, CO 81506-8733 | 2006-09-20 |
| 1699709204 | Kelly L King | Physical Therapist | 309 Highway 641 N, Camden, TN 38320-3011 | 2006-07-10 |
| 1114998606 | Kelly Ennix King | Internal Medicine | 6901 Simmons Loop, 4th Floor, Riverview, FL 33578-9498 | 2006-02-01 |
| 1659355410 | Kelly Ann King | Internal Medicine | 1835 Oddie Blvd, Sparks, NV 89431-3559 | 2005-12-05 |
| 1063049062 | Kelly King | Student in an Organized Health Care Education/Training Program | 272 Congress St, Portland, ME 04101-3637 | 2020-03-27 |
| 1811527823 | Kelly King | Behavioral Analyst | 1000 Plantation Rd Ste D, Thibodaux, LA 70301-4264 | 2020-01-17 |
| Street Address |
3600 JOSEPH SIEWICK DR |
| City | FAIRFAX |
| State | VA |
| Zip Code | 22033 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407854250 | Maria Lucille Fain | Nurse Anesthetist, Certified Registered | 3600 Joseph Siewick Dr, Fairfax, VA 22033-1709 | 2005-07-14 |
| 1679171847 | Lucy Holden Cusack | Registered Nurse | 3600 Joseph Siewick Dr, Fairfax, VA 22033-1709 | 2020-10-11 |
| 1346854189 | Kathleen Nicole Jennings | Registered Nurse | 3600 Joseph Siewick Dr, Fairfax, VA 22033-1709 | 2020-08-31 |
| 1730792649 | Amy Christine Byerle | Registered Nurse | 3600 Joseph Siewick Dr, Fairfax, VA 22033-1709 | 2020-08-29 |
| 1184235863 | Nancy Lynn Forrest | Registered Nurse | 3600 Joseph Siewick Dr, Fairfax, VA 22033-1709 | 2020-08-14 |
| 1639780323 | Laura Ann Cintorino | Registered Nurse | 3600 Joseph Siewick Dr, Fairfax, VA 22033-1709 | 2020-08-14 |
| 1366053332 | Elizabeth Abando | Registered Nurse | 3600 Joseph Siewick Dr, Fairfax, VA 22033-1709 | 2020-08-13 |
| 1124639992 | Sarah A Mcdonald | Registered Nurse | 3600 Joseph Siewick Dr, Fairfax, VA 22033-1709 | 2020-08-13 |
| 1134633597 | Previtha Sanna Mathews | Nurse Anesthetist, Certified Registered | 3600 Joseph Siewick Dr, Fairfax, VA 22033-1709 | 2017-11-21 |
| 1427590629 | Qian Feng | Specialist/Technologist, Other | 3600 Joseph Siewick Dr, Fairfax, VA 22033-1709 | 2016-11-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366074320 | Han S Yoo | Pharmacist | 12200 West Ox Road, Fairfax, VA 22033 | 2020-02-07 |
| 1386137271 | Ammar Orthodontics Pllc | Dentist | 11702 Fiar Oaks Mall, Upper Floor, Fairfax, VA 22033 | 2018-06-14 |
| 1013360940 | Kellyn Patricia Dodd | Nurse Practitioner | 3903 Fair Ridge Dr Ste 209, Fairfax, VA 22033 | 2016-07-15 |
| 1659721363 | John Du Od PC | Optometrist | 12618 Victoria Station Ct, Fairfax, VA 22033 | 2016-06-14 |
| 1568861904 | Virginia Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 12734 Shoppes Lane, Fairfax, VA 22033 | 2014-08-21 |
| 1649696295 | Patrisha Lultschik | Nurse Practitioner | 12375 Lee Jackson Memorial Hwy, Fairfax, VA 22033 | 2014-03-06 |
| 1912321910 | Alyson Huber | Nurse Anesthetist, Certified Registered | 3600 Joseph Siewick Dr., Fairfax, VA 22033 | 2014-02-11 |
| 1578999314 | Aiatulah Surmaty | Optometrist | 11801 Lee Jackson Memorial Hwy, Fairfax, VA 22033 | 2013-09-25 |
| 1356780928 | Ayatallah M. Khafagy | Obstetrics & Gynecology | 3650 Joseph Siewick Dr Suite 203, Fairfax, VA 22033 | 2013-06-17 |
| 1760726665 | Michelle Elise Schwartz | Speech-Language Pathologist | 3507 Curtice Farm Dr, Fairfax, VA 22033 | 2012-11-15 |
| Find all providers in zip 22033 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285955732 | Peggy Lee Carlson | Emergency Medicine | 3293 Tilton Valley Dr, Fairfax, VA 22033-1804 | 2010-06-18 |
| 1356570071 | Azmy A. Iskander | Emergency Medicine | 10520 Acacia Lane, Fairfax, VA 22032 | 2009-07-02 |
| 1205911658 | Bestpractices, Inc. | Emergency Medicine | 4315 Chain Bridge Rd, Fairfax, VA 22030-3061 | 2006-10-26 |
| 1427068105 | Janne Bowen-williams | Emergency Medicine | 773 Center Blvd, Box 400, Fairfax, CA 94930-1738 | 2006-08-08 |
| 1760429476 | Michael Sean Antonis | Emergency Medicine | 8501 Arlington Blvd Ste 400, Fairfax, VA 22031-4625 | 2006-06-01 |
| 1710965520 | Steven Roy Burkholz | Emergency Medicine | 10306 Eaton Pl, Suite 180, Fairfax, VA 22030-2201 | 2006-01-03 |
| 1568758670 | Abdulahad Asif Rehmatulla | Emergency Medicine | 3600 Joseph Siewick Dr, Fairfax, VA 22033-1709 | 2011-06-27 |
| 1831410497 | Thania Violeta Lamirand | Emergency Medicine | 3022 Williams Dr, Suite 300, Fairfax, VA 22031-4600 | 2010-06-17 |
| 1427374727 | Neal Hyatt Shelley | Emergency Medicine | 10306 Eaton Pl, Suite 180, Fairfax, VA 22030-2201 | 2010-04-12 |
| 1265609788 | Kara S Cochran | Emergency Medicine | 3600 Joseph Siewick Dr, Inova Fair Oaks Hospital, Fairfax, VA 22033-1709 | 2008-05-14 |
| Find all providers in FAIRFAX | ||||
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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.