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MRS. SHADARA KING AGNP-C
NPI 1093286015
Nurse Practitioner in Raleigh, NC

Active since December 17, 2018PECOS Enrolled
3214 CHARLES B ROOT WYND STE 203, RALEIGH, NC 27612(919) 877-6800(844) 881-7701 Get Directions Write a Review

NPPES record last updated: July 7, 2023. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jul 7, 2023, Apr 8, 2020, Dec 19, 2018 (3 updates tracked since 2018).

About Mrs. Shadara King Agnp-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MRS. SHADARA KING AGNP-C (NPI 1093286015) is an individual nurse practitioner in Raleigh, North Carolina, licensed in North Carolina (5011293) and active in the NPI registry since December 2018. She is enrolled in Medicare PECOS and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1093286015
Entity TypeIndividualFemale
Primary Taxonomy363L00000X
Provider Legal NameMRS. SHADARA KINGCredential: AGNP-C
Location Address3214 CHARLES B ROOT WYND STE 203Raleigh, NC 27612-5440
Mailing Address185 Timber Wolf XingGarner, NC 27529-9279 · (302) 228-6434 · Fax (910) 348-7961
Phone(919) 877-6800
Fax(844) 881-7701
Sole ProprietorYes
Enumeration DateDecember 17, 2018
Last NPPES UpdateJuly 7, 20233 updates tracked since enumeration
NPPES CertifiedMarch 17, 2022
✔ NPI 1093286015 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
Licenses✔ Licensed in NC · 5011293✔ Licensed in DE · LP-0010645✔ Licensed in TN · 33592✔ Licensed in SC · 27576✔ Licensed in AL · 3-001270
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
Also ListedNurse Practitioner · Adult HealthTaxonomy 363LA2200X · License 5011293 (NC), AG03180040 (GA)
3214 CHARLES B ROOT WYND STE 203, Raleigh, NC 27612
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Other Names 1

Former Name (1)Shadara Edmond

Secondary Practice Locations 2

Location 16000 Poplar Ave Ste 250Memphis, TN 38119-3974 · Phone (901) 625-5408
Location 23508 Market St Ste 213Philadelphia, PA 19104-3320 · Phone (267) 754-8400

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include AmeriHealth Caritas Next.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mrs. Shadara King Agnp-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

2

Medicare enrollment records show Shadara King reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Eclipse Wellness LLC
315 mi
Pain Medicine
623 W NEWPORT PIKE
Wilmington, DE 19804
  • Reassigned Medicare billing, Delaware enrollment
NPI 1245992262 (302) 777-5473
Signify Health, LLC
1,056 mi
General Practice
4055 VALLEY VIEW LN STE 700
Dallas, TX 75244
  • Reassigned Medicare billing, Delaware enrollment
  • 78 clinicians in this Medicare group
NPI 1689158487 (469) 466-7007

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 27612 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$83.90 typical visit price
range $54.12 – $165.09
Typical copayment $20.97 (range $13.53 – $41.27)
Most-billed visit code 99203
Established Patient
$95.94 typical visit price
range $17.21 – $134.61
Typical copayment $23.98 (range $4.30 – $33.65)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ACTIFY NEUROTHERAPIES PLLC
Psychiatry & Neurology (Psychiatry)
3214 CHARLES B ROOT WYND STE 203
RALEIGH, NC 27612
Wake County (888) 566-8774
NICOLE JOSLIN APRN
Nurse Practitioner (Psychiatric/Mental Health)
3214 CHARLES B ROOT WYND STE 203
RALEIGH, NC 27612
Wake County (919) 785-5055

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Shadara King's NPI number?

The NPI number for Shadara King is 1093286015. It was assigned to this individual provider in the NPPES registry on December 17, 2018. The provider is also known as Shadara Edmond.

Where is Shadara King located?

Shadara King practices at 3214 Charles B Root Wynd Ste 203, Raleigh, NC 27612. The listed phone number is (919) 877-6800.

What is Shadara King's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Is Shadara King enrolled in Medicare?

Yes. Shadara King is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Shadara King's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Shadara King reassigns Medicare benefits to 2 organizations: Eclipse Wellness LLC (Wilmington, DE) and Signify Health, LLC (Dallas, TX). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Shadara King's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Shadara King accept?

Health plans from AmeriHealth Caritas Next list Shadara King as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Shadara King was last updated on July 7, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.