Active NPI
Tony JB Park, PHARM.D.
- Pharmacist
- Bethesda, MD
National Provider Identifier
1053635862
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 18923
- Practice address
- 8901 Wisconsin Ave
Bethesda, MD 20889 - Phone
- (301) 295-0671
- NPI assigned
- Mar 23, 2010
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 18923 | MD | Primary |
Addresses
Primary practice location
8901 Wisconsin Ave
Bethesda, MD 20889
Mailing address
14014 Connecticut Ave
Silver Spring, MD 20906-2922
Phone (301) 460-3402
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)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18923 | MD | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1269302400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1529452800000",
"number": "1053635862",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14014 CONNECTICUT AVE",
"city": "SILVER SPRING",
"state": "MD",
"postal_code": "209062922",
"telephone_number": "301-460-3402"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8901 WISCONSIN AVE",
"city": "BETHESDA",
"state": "MD",
"postal_code": "20889",
"telephone_number": "301-295-0671"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PARK",
"first_name": "TONY",
"middle_name": "JB",
"name_prefix": "Dr.",
"credential": "PHARM.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-03-23",
"last_updated": "2018-06-20",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MD",
"license": "18923",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bethesda, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.