DR. JACK DENNIS KING (NPI# 1922050780) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922050780 |
| Entity Type | Individual |
| Full Name | DR. JACK DENNIS KING |
| Credential | MD |
| Practice Address |
3094 W Market St Suite 103 Fairlawn OH 44333-3626 |
| Practice Telephone | 3308369397 |
| Practice Fax Number | 3308360907 |
| Mailing Telephone | 3308369397 |
| Mailing Fax Number | 3308360907 |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2008-03-04 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 35044194 | OH | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | 0420306 OH | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811992332 | Jack Douglas King | Dentist | 1706 Davie Ave, Ste B, Statesville, NC 28677-3589 | 2005-06-21 |
| 1649811902 | Jack King | Speech-Language Pathologist | 2501 Rice Lake Rd, Duluth, MN 55811-4819 | 2019-10-07 |
| 1477916450 | Jack D King IIi | Technician, Other | 440 N Main St, Imlay City, MI 48444-1151 | 2016-03-29 |
| 1164563706 | Jack Donald King Jr. | Family Medicine | 1826 Ailor Ave, Knoxville, TN 37921-5802 | 2007-02-08 |
| Street Address |
3094 W MARKET ST SUITE 103 |
| City | FAIRLAWN |
| State | OH |
| Zip Code | 44333-3626 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669454302 | John Herbert Gerstenmaier Jr. | Dentist | 3094 W Market St, #260, Fairlawn, OH 44333-3626 | 2005-11-17 |
| 1093329724 | Kristyn Lein | Counselor | 3094 W Market St, Fairlawn, OH 44333-3626 | 2020-09-01 |
| 1164056552 | Christina D Smith | Community Health Worker | 3094 W Market St, Fairlawn, OH 44333-3626 | 2020-02-25 |
| 1760884241 | Pamela Irene Hirt | Marriage & Family Therapist | 3094 W Market St, Fairlawn, OH 44333-3626 | 2014-09-16 |
| 1831511906 | Jacklyn Hofmann | Counselor | 3094 W Market St, Suite 105, Fairlawn, OH 44333-3626 | 2014-01-09 |
| 1578998688 | Corey M. Fling | Counselor | 3094 W Market St, Suite 105, Fairlawn, OH 44333-3626 | 2013-09-08 |
| 1831523760 | Elizabeth S. Helmuth | Counselor | 3094 W Market St, Fairlawn, OH 44333-3626 | 2013-08-28 |
| 1710328109 | Angela M Brown | Counselor | 3094 W Market St, Suite 105, Fairlawn, OH 44333-3626 | 2013-07-12 |
| 1043463219 | Summa Physicians Inc | Family Medicine | 3094 W Market St, Ste. 136, Fairlawn, OH 44333-3626 | 2008-10-31 |
| 1083895460 | Roth Family Medicine,ltd. | Clinic/Center | 3094 W Market St, Suite 136, Fairlawn, OH 44333-3626 | 2007-11-14 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083223341 | National Vision Inc | Optometrist | 2665 West Market Street, Fairlawn, OH 44333 | 2020-07-23 |
| 1619468105 | Yellow Creek Primary Care, Inc. | Family Medicine | 3453 Granger Rd, Akron, OH 44333 | 2018-05-21 |
| 1336655984 | Laura Ann Starkey | Nurse Practitioner | 3562 Ridge Park Dr # D1, Fairlawn, OH 44333 | 2017-12-19 |
| 1952814329 | Linda Long | Behavioral Analyst | 3428 W. Market Street, Fairlawn, OH 44333 | 2017-11-08 |
| 1366967325 | Heidi Harper | Behavioral Analyst | 373 Stratford Rd., Fairlawn, OH 44333 | 2017-08-10 |
| 1215459151 | Lisa Marie Kosley | Registered Nurse | 3250 West Market, Suite 2, Fairlawn, OH 44333 | 2017-07-12 |
| 1053764530 | Lindsey Foradis | Nurse Practitioner | 3600 W Market St Ste 200, Fairlawn, OH 44333 | 2016-07-19 |
| 1922484740 | Let's Talk Quality Services, Inc. | Day Training, Developmentally Disabled Services | 462 Gresham Drive, Fairlawn, OH 44333 | 2015-08-04 |
| 1770973240 | Amelia Evans | Licensed Practical Nurse | 3040 West Market St., Interim Healthcare, Akron, OH 44333 | 2015-02-04 |
| 1770908774 | Mary Catherine Boettcher | Speech-Language Pathologist | 150 N. Miller Rd., Suite # 150 A, Akron, OH 44333 | 2014-02-27 |
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| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881918431 | Forrest W Crocker | Pediatrics | 700 W Point Dr, Fairlawn, OH 44333-2656 | 2010-03-24 |
| 1841392800 | Gunjan Pradhan | Pediatrics | 17-10 Fairlawn Ave, Fairlawn, NJ 07410 | 2006-09-01 |
| 1093770901 | Patricia Cremin | Pediatrics | 23-00 Rt 208 S, Maple Ave Pediatrics, Fairlawn, NJ 07410 | 2006-04-20 |
| 1205828035 | Sigmund Carl Norr | Pediatrics | 2640 W Market St, Fairlawn, OH 44333-4202 | 2005-08-18 |
| 1194717199 | Lori J Davello | Pediatrics | 3800 Embassy Pkwy Ste 260, Fairlawn, OH 44333-8398 | 2005-08-17 |
| 1033546023 | Healthspan Integrated Care | Pediatrics | 4055 Embassy Pkwy, Suite 110, Fairlawn, OH 44333-1781 | 2013-10-04 |
| 1679890792 | Deanna Marie Barry | Pediatrics | 3800 Embassy Pkwy Ste 260, Fairlawn, OH 44333-8398 | 2010-04-29 |
| 1619932522 | Maple Avenue Pediatrics | Pediatrics | 23-00 Rt 208 S, Maple Ave Pediatrics, Fairlawn, NJ 07410 | 2006-04-20 |
| 1952367898 | Kathleen Greaney | Pediatrics | 23-00 Rt 208 S, Maple Ave Pediatrics, Fairlawn, NJ 07410 | 2006-04-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184237968 | Greater Cleveland Pediatrics | Pediatrics | 3311 Richmond Rd, Beachwood, OH 44122-4195 | 2020-08-31 |
| 1528677085 | Mariam Khan | Pediatrics | 2277 Summit St, Columbus, OH 43202-3131 | 2020-07-30 |
| 1447879200 | Amy C Buck | Pediatrics | 30 Kim Ct W, Westerville, OH 43081-2554 | 2020-04-13 |
| 1376170381 | Kathleen Sibyl Kress Farrell | Pediatrics | 14701 Detroit Ave Ste 250, Lakewood, OH 44107-4109 | 2020-03-27 |
| 1710526702 | Rebecca K Cibik | Pediatrics | 2497 State Route 59, Kent, OH 44240 | 2019-12-23 |
| 1992354344 | Rouba Sayegh | Pediatrics | 315 Frankfort Sq, Columbus, OH 43206-1061 | 2019-09-09 |
| 1972164556 | Grace Nikolai | Pediatrics | 9000 N Main St Ste 332, Englewood, OH 45415-1185 | 2019-06-25 |
| 1376012393 | Ohio North East Health Systems, Inc | Pediatrics | 2642 State Route 5, Cortland, OH 44410-9393 | 2018-11-20 |
| 1477022606 | Anthony George Pucell | Pediatrics | 1120 Gordon Rd, Lyndhurst, OH 44124-1335 | 2018-11-16 |
| 1861988875 | Sandeep Randhawa | Pediatrics | Rupert Health Centre, Utmc Campus, 3125, Transverse Drive, Toledo, OH 43614 | 2018-07-03 |
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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.