WILLIAM SCOTT JR. KING (MD) – Surgery Physician, NPI 1104936475

WILLIAM SCOTT JR. KING (MD) is a healthcare provider. based in Memphis, Tennessee. specializing in Surgery Physician. They hold the professional credentials MD. They hold a License No. 8918 (TN). The NPI Number for WILLIAM SCOTT JR. KING (MD) is 1104936475

Main info

Male
53 Years Of Experience
Accepts Medicare Assignment
Name
WILLIAM SCOTT JR. KING (MD)
NPI
1104936475
Phone
(901) 726-1056
Address
6029 WALNUT GROVE RD
Enumeration Date
30 August 2006
Last Update Date
29 March 2010

Doctor Profile

Medical School Name
UNIVERSITY OF TENNESSEE, HSC, COLLEGE OF MEDICINE
Secondary Phone
9017261056
Graduation Year
1973 (53 years ago)
PAC ID
1557396843
Group Practice PAC ID
2365701943
Professional Enrollment ID
I20051005001018
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

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Provider Addresses for WILLIAM SCOTT JR. KING (MD)

  • 6029, Walnut Grove Road, Memphis, Shelby County, Tennessee, 38120, United States

    SUITE 404

    MEMPHIS, TN 381202112

    Phone: (901) 726-1056

    Fax: (901) 726-5867

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2005-10-05

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20051005001018IGeneral SurgeryTNTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 38120)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 2365701943View full group profile
NameSpecialtyState
Cardiovascular Disease (Cardiology), Internal MedicineTN
General SurgeryTN
Family PracticeTN
Family PracticeTN
Interventional Cardiology, Cardiovascular Disease (Cardiology)TN
General SurgeryTN
Physician AssistantMS
-TN
Physician AssistantTN
Nurse PractitionerTN

Reviews

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Frequently asked questions

What number should I use to identify WILLIAM SCOTT JR. KING (MD) for billing?
Administrative and clinical systems typically use NPI 1104936475 for WILLIAM SCOTT JR. KING (MD).
Should I treat WILLIAM SCOTT JR. KING (MD) as an active provider?
Patients and plans typically see WILLIAM SCOTT JR. KING (MD) as active in the national extract.
What type of care does WILLIAM SCOTT JR. KING (MD) provide?
WILLIAM SCOTT JR. KING (MD)'s profile centers on Surgery Physician. Clinical services aligned with this taxonomy classification.
Can patients visit WILLIAM SCOTT JR. KING (MD) in Memphis, Tennessee?
For routing, start with Memphis, Tennessee for WILLIAM SCOTT JR. KING (MD), then verify phone and hours locally.
Who maintains WILLIAM SCOTT JR. KING (MD)'s record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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