Nuri Park, NP

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

NP16060 Issued in CA

Practice address

750 N Saint Paul St Ste 1340
Dallas, TX 75201-7111

Phone

(855) 961-1942

Fax

(866) 702-0882

NPI assigned

Feb 6, 2007

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: nuri.park.1@14883.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Healthcare Partners Affiliates Medical Group

  • Internal Medicine Physician
  • Los Angeles, CA
  • NPI 1659312593
  Medicare reassignment NPD
• Housecall Doctors Medical Group Inc

  • Geriatric Medicine (Family Medicine) Physician
  • Long Beach, CA
  • NPI 1033164017
  Medicare reassignment NPD
• William Wang DO, a Medical Corporation

  • Family Medicine Physician
  • Hacienda Heights, CA
  • NPI 1528839263
  Medicare reassignment NPD
• Healthcare Partners Affiliates Medical Group

  • Durable Medical Equipment & Medical Supplies
  • Murrieta, CA
  • NPI 1760057269
  NPD
• Healthcare Partners Affiliates Medical Group

  • Addiction Medicine (Internal Medicine) Physician
  • Tustin, CA
  • NPI 1891981502
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638316800000",
    "number": "1003955667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 N SAINT PAUL ST STE 1340",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752017111",
            "telephone_number": "855-961-1942",
            "fax_number": "866-702-0882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 N SAINT PAUL ST STE 1340",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752017111",
            "telephone_number": "855-961-1942",
            "fax_number": "866-702-0882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "NURI",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-06",
        "last_updated": "2021-12-01",
        "certification_date": "2021-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "CA",
            "license": "NP16060",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joonho Park, M.D.
• Ki Eun Park, M.D.
• Krystal Blair Park
• Marisol Park, LPC
• Minkyung Park, M.D.
• Rachel Park, DO
• Sang Park
• Sanghoon Park, MD
• Sangwook Park
• So Myung Park, DO

• Gerontology Nurse Practitioner in Dallas, TX
• Providers in Dallas, TX by specialty
• Gerontology Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.