Active NPI
Jason Andrew Park
- Occupational Medicine Physician
- Colorado Springs, CO
National Provider Identifier
1053999250
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Medicine Physician
- License
- DR.0070080
- Practice address
- 1495 Garden of the Gods Rd Ste 102
Colorado Springs, CO 80907-3429 - Phone
- (719) 260-9797
- NPI assigned
- Mar 30, 2021
- Last updated
- Jan 26, 2023
- 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 |
|---|---|---|---|---|
| Occupational Medicine Physician | 2083X0100X | DR.0070080 | CO | Primary |
Addresses
Primary practice location
1495 Garden of the Gods Rd Ste 102
Colorado Springs, CO 80907-3429
Mailing address
1495 Garden of the Gods Rd Ste 102
Colorado Springs, CO 80907-3429
Medicare participation
Medicare enrollment files- 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
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DR.0070080 | CO | MD | Occupational Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1617062400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1674691200000",
"number": "1053999250",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1495 GARDEN OF THE GODS RD STE 102",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809073429"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1495 GARDEN OF THE GODS RD STE 102",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809073429",
"telephone_number": "719-260-9797"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PARK",
"first_name": "JASON",
"middle_name": "ANDREW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-03-30",
"last_updated": "2023-01-26",
"certification_date": "2023-01-26",
"status": "A"
},
"taxonomies": [
{
"code": "2083X0100X",
"taxonomy_group": "",
"desc": "Preventive Medicine, Occupational Medicine",
"state": "CO",
"license": "DR.0070080",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Colorado Springs, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2023; 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.