Soomin Park

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CHIR008959 Issued in GA

Practice address

143 Powers Ferry Rd SE
Marietta, GA 30067-7541

Phone

(770) 509-5558

NPI assigned

Nov 7, 2013

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Thera Chiropractic LLC

  • Chiropractor
  • Suwanee, GA
  • NPI 1649939943
  NPD Authorized official

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

{
    "created_epoch": "1383782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383782400000",
    "number": "1043649254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "143 POWERS FERRY RD SE",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300677541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "143 POWERS FERRY RD SE",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300677541",
            "telephone_number": "770-509-5558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "SOOMIN",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-11-07",
        "last_updated": "2013-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIR008959",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ji Won Park, DMD
• Jong Bume Park, LAC
• Jong-Beak Park, R.PH., PH.D.
• Jungsub Park, D.C.
• Michelle Park, MD
• Parkaire Consultants, Inc.
• Christie Ellen Parker, NP
• Elizabeth Parker, OT
• Jasmine Sade Parker
• John Mark Parker, MS, MDIV/CE, NCC

• Chiropractor in Marietta, GA
• Providers in Marietta, GA by specialty
• Chiropractor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.