Kelly Ann Fumie Park, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2475 Issued in HI

Practice address

850 W Hind Dr
Suite 104 and 108
Honolulu, HI 96821-1855

Phone

(808) 373-4787

NPI assigned

Nov 15, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in HI

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Park Physical Therapy LLCGroup PAC ID 8628404605, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Park Physical Therapy, LLC

  • Physical Therapy Clinic/Center
  • Honolulu, HI
  • NPI 1154962660

  Physical Therapist

  Medicare reassignment Care Compare group NPD Authorized official
• Jing Ching Sally Ho

  dba Ho Physical Therapy

  • Physical Therapist
  • Beverly Hills, CA
  • NPI 1972660579
  NPD (past)

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1073686630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 W HIND DR",
            "address_2": "SUITE 104 AND 108",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968211855",
            "telephone_number": "808-373-4787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 W HIND DR",
            "address_2": "SUITE 104 AND 108",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968211855",
            "telephone_number": "808-373-4787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "KELLY",
        "middle_name": "ANN FUMIE",
        "name_prefix": "Ms.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-15",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "HI",
            "license": "2475",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HMSA QUEST PROV. NUMBER",
            "identifier": "0000255364",
            "state": "HI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HMSA PROVIDER NUMBER",
            "identifier": "0000255364",
            "state": "HI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNIVERSITY HEALTH ALLIANC",
            "identifier": "2695487",
            "state": "HI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "57436001",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jenna Sohee Park
• Jennifer Park
• Jihyun Park, MD
• Jihyun Park
• Jiin Park, DPT, PT
• Lina Park
• Melanie Park, APRN
• Philip Duheung Park, DDS
• Sarah Y. Park, M.D.
• Sharon Park, MD

• Physical Therapist in Honolulu, HI
• Providers in Honolulu, HI by specialty
• Physical Therapist in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.