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1700334463

NPI Code Detail

MEDICARE: JESSICA ANN KING PT, DPT

MEDICARE: JESSICA ANN KING PT, DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	CP030127T	OH
2	225100000X	Physical Therapist	CP008785T	CO
3	225100000X	Physical Therapist	CP003729T	WA
4	225100000X	Physical Therapist	2305213851	VA
5	225100000X	Physical Therapist	CP043325T	NC
6	225100000X	Physical Therapist	302239	CA
7	225100000X	Physical Therapist	PT032180	PA
8	225100000X	Physical Therapist	CP027747T	GA
9	225100000X	Physical Therapist	CP030161T	MO
10	225100000X	Physical Therapist	CP027748T	TN
11	225100000X	Physical Therapist	1363029	TX

General Provider Information

NPI Number	:	1700334463
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA ANN KING PT, DPT

Provider Business Mailing Address
First Line	:	2001 BUTTERFIELD RD STE 1600
Second Line	:
City	:	DOWNERS GROVE
State	:	IL
Zip	:	60515-1211
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	16139 LANCASTER HWY STE 140
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28277-2976
Country	:	US
Telephone Number	:	866-483-5378
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/12/2016
Last Update Date	:	08/25/2025

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Directions to “ JESSICA ANN KING PT, DPT” Practice Location

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