Jade Park

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

01093877A Issued in IN

Practice address

301 4TH St
Alexandria, LA 71301-8411

Phone

(318) 441-1041

NPI assigned

Jun 9, 2021

Sex

Female

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

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Hospitalist Physicians of Indiana, PC

  • Hospitalist Physician
  • Fort Wayne, IN
  • NPI 1306576277

  Family Medicine

  NPD

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

{
    "created_epoch": "1623196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726099200000",
    "number": "1053988741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 4TH ST",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "713018411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 4TH ST",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "713018411",
            "telephone_number": "318-441-1041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "JADE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-09",
        "last_updated": "2024-09-12",
        "certification_date": "2024-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01093877A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Palliative Care at Heart, LLC
• Suzanne P Palmer, MA,NCC,LAC,LPC
• Sunita Pannachan
• Parham Bahador, LLC
• Martha Trimble Parham, LCSW
• Alyssa Parker
• Brooke Chaney Parker, RSW
• Hunter Blake Parker, PTA
• Jarrod Benjamin Parker, CRNA
• Larry Parker, MD

• Family Medicine Physician in Alexandria, LA
• Providers in Alexandria, LA by specialty
• Family Medicine Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2024; 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.