Jeanie Park, M.D.

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

061137 Issued in GA

Practice address

550 Peachtree St NE
Mot 8TH Floor
Atlanta, GA 30308-2208

Phone

(404) 686-5038

Fax

(404) 686-4995

NPI assigned

Oct 16, 2007

Last updated

May 17, 2011By the provider in NPPES

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 GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jpark49664@direct.emory.org

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

• The Emory Clinic Inc

  • Internal Medicine Physician
  • Atlanta, GA
  • NPI 1396798229

  Nephrology

  Medicare reassignment NPD
• Emory Health Care

  • Neurology Physician
  • Atlanta, GA
  • NPI 1376642751
  NPD (past)

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

{
    "created_epoch": "1192492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1305590400000",
    "number": "1043409048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1670 CLAIRMONT RD",
            "address_2": "RENAL/NEPHROLOGY AND HEMODIALYSIS MED (111)",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300334004",
            "telephone_number": "404-321-6111",
            "fax_number": "404-235-3049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 PEACHTREE ST NE",
            "address_2": "MOT 8TH FLOOR",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303082208",
            "telephone_number": "404-686-5038",
            "fax_number": "404-686-4995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "JEANIE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-16",
        "last_updated": "2011-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "GA",
            "license": "061137",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eunhye Park
• Hailey Kyung Yeon Park, DDS
• Jae Yeon Park, DMD
• James Park, D.M.D
• Jasmine Jungmin Park, D.O.
• Jin Park, M.D.
• Jina Park
• Jonathan Park, PHARMD
• Judy Park
• Jung Mi Park, M.D.

• Nephrology Physician in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Nephrology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2011; 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.