KING DERMATOLOGY
NPI 1619107398
Dermatology in Mountain Home, AR
About King Dermatology NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KING DERMATOLOGY (NPI 1619107398) is a healthcare organization registered as a dermatology in Mountain Home, Arkansas and active in the NPI registry since July 2009. The organization holds a CLIA Waiver certificate valid through May 22, 2028 and lists Mark Steven King, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Other Identifiers 1
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
King Dermatology is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by February 28, 2027
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
4Medicare enrollment records show 4 clinicians reassign Medicare billing to King Dermatology, which bills Medicare for the services they deliver. Of these, 3 practice at this address. They are listed nearest first.
Clinicians, nearest first (4)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 04D2229479
Mark S King MD PA · Mountain Home, ARFrequently 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 Mark S King, MD, PA's NPI number?
The NPI number for Mark S King, MD, PA is 1619107398. It was assigned to this organization in the NPPES registry on July 16, 2009. The provider is doing business as King Dermatology.
Where is Mark S King, MD, PA located?
Mark S King, MD, PA is located at 2062 Highway 62 W, Mountain Home, AR 72653. The listed phone number is (870) 425-5464.
What is Mark S King, MD, PA's specialty?
The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.
Is Mark S King, MD, PA enrolled in Medicare?
Yes. Mark S King, MD, PA is registered in the Medicare PECOS enrollment system.
When is Mark S King, MD, PA's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Arkansas, Clinic/Group Practice) is due for revalidation by February 28, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through Mark S King, MD, PA?
According to the CMS Revalidation Reassignment List (October 2026 release), 4 clinicians reassign their Medicare billing to Mark S King, MD, PA, in Dermatology, Nurse Practitioner and Sports Medicine. A 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 the clinician's services. Of these, 3 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Mark S King, MD, PA hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 04D2229479) is associated with this NPI, valid through May 22, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Mark S King, MD, PA accept?
Health plans from Ambetter Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Superior HealthPlan and Ambetter of Oklahoma and 1 other insurer list Mark S King, MD, PA 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 Mark S King, MD, PA was last updated on August 24, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.
# King Dermatology · NPI 1619107398
Dermatology organization in Mountain Home, Arkansas. Organization record, active in the CMS NPPES registry since July 16, 2009.
## Identity
- **NPI:** 1619107398 (Entity type: Organization)
- **Enumerated:** July 16, 2009
- **Primary specialty:** Dermatology · taxonomy 207N00000X
- **Legal business name:** Mark S King, Md, Pa
- **Organization subpart:** No
- **Authorized official:** Mark King, OWNER
## Practice location
- **Address:** 2062 HIGHWAY 62 W, Mountain Home, AR 72653-7656
- **Phone:** (870) 425-5464 · **Fax:** (870) 425-5465
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** February 28, 2027 (Non-DME Part B, Arkansas, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 4 clinicians in 3 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Dermatology (2), Nurse Practitioner (1), Sports Medicine (1); 3 practice at this address · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** August 24, 2022
- **Other identifiers:** Medicaid 179411002 (AR)
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1619107398) · Data from the CMS NPPES public registry.