Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mrs. Shadara King, AGNP-C

Individual provider Nurse Practitioner · NPI 1093286015

Mrs. Shadara King, AGNP-C is a Nurse Practitioner in Raleigh, North Carolina. Qualified in 2017, 9 years ago. Practices as a sole proprietor, works from 3 locations and accepts Medicare assignment. Licensed in Alabama, Delaware, Georgia and North Carolina and 2 more.

Years since qualifying
9
Licensed in
AL, DE, GA, NC, SC, TN
In the registry since
2018
Specialties on file
7
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Practice location Address checks out

3214 Charles B Root Wynd Ste 203
Raleigh, NC 27612-5440
Phone: (919) 877-6800
Fax: (844) 881-7701
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 3508 Market St Ste 213, Philadelphia, PA 19104-3320 — (267) 754-8400
  • 6000 Poplar Ave Ste 250, Memphis, TN 38119-3974 — (901) 625-5408

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence 5011293 (NC)
Nurse Practitioner Taxonomy 363L00000X · Licence LP-0010645 (DE)
Nurse Practitioner Taxonomy 363L00000X · Licence 33592 (TN)
Nurse Practitioner Taxonomy 363L00000X · Licence 27576 (SC)
Nurse Practitioner Taxonomy 363L00000X · Licence 3-001270 (AL)
Adult Health Nurse Practitioner Taxonomy 363LA2200X · Licence 5011293 (NC)
Adult Health Nurse Practitioner Taxonomy 363LA2200X · Licence AG03180040 (GA)

Record details

NPI number1093286015
Entity typeIndividual (Type 1)
GenderFemale
Credentials AGNP-C
Sole proprietorYes
NPI enumeratedDecember 17, 2018
Last updated in NPPESJuly 7, 2023
Certification dateMarch 17, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Raleigh