Jung Eun Park, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

0101256067 Issued in VA

Practice address

6345 Center Dr BLDG 14
Norfolk, VA 23502-4105

Phone

(757) 461-4027

NPI assigned

Apr 10, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Childrens Medical Group Inc

  • Pediatrics Physician
  • Virginia Beach, VA
  • NPI 1366597114
  NPD (past)

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

{
    "created_epoch": "1302393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1053601161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 CHILDRENS LN",
            "address_2": "EVMS PEDIATRICS",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235071910",
            "telephone_number": "757-668-7272",
            "fax_number": "757-668-9766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6345 CENTER DR BLDG 14",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235024105",
            "telephone_number": "757-461-4027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "JUNG",
        "middle_name": "EUN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-04-10",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "VA",
            "license": "0101256067",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pariser Dermatology Specialists LTD
• David Pariser, M.D.
• Robert J. Pariser, M.D.
• Thomas George Parish, PA-C
• Maria Z. Parizhskaya, MD
• Kyulee Park, PHD, LPC, NCC
• Youn Seon Park, DDS
• Parker Schlichter & Associates
• Parker Transportation LLC
• Jacob Parker, DMD

• Pediatrics Physician in Norfolk, VA
• Providers in Norfolk, VA by specialty
• Pediatrics Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.