Active NPI
Jinkyung Pak, PA
- Physician Assistant
- Raleigh, NC
National Provider Identifier
1043653876
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 001003992
- Practice address
- 141 Park at North Hills St
Ste #116
Raleigh, NC 27609-5989 - Phone
- (800) 234-3325
- NPI assigned
- Apr 11, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 001003992 | NC | Primary |
Addresses
Primary practice location
141 Park at North Hills St
Ste #116
Raleigh, NC 27609-5989
Mailing address
3005 Gross Ave
Wake Forest, NC 27587-6493
Phone (919) 426-8031
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 001003992 | NC | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1365638400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1365638400000",
"number": "1043653876",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3005 GROSS AVE",
"city": "WAKE FOREST",
"state": "NC",
"postal_code": "275876493",
"telephone_number": "919-426-8031"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "141 PARK AT NORTH HILLS ST",
"address_2": "STE #116",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276095989",
"telephone_number": "800-234-3325"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PAK",
"first_name": "JINKYUNG",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-04-11",
"last_updated": "2013-04-11",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NC",
"license": "001003992",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Raleigh, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 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.