Park Surgical Specialists, LLC

Primary specialty

SpecialistTaxonomy code 174400000X

License

32801 Issued in GA

Legal business name

PARK SURGICAL SPECIALISTS, LLC

Practice address

4255 Johns Creek Pkwy Ste D
Suwanee, GA 30024-6122

Phone

(404) 414-8047

NPI assigned

Jan 12, 2018

Organization subpart

No

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

Authorized official

Name

Terri McDonald

Title

Credentialing

Phone

(404) 414-8047

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/17177/brand/1/csg/1/fhir/r4

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Alexander D. Park, M.D.

  • Surgery Physician
  • Suwanee, GA
  • NPI 1710946314
  Medicare reassignment Care Compare group NPD
• David D. Park, M.D.

  • Surgery Physician
  • Atlanta, GA
  • NPI 1114986569
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1515715200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1538352000000",
    "number": "1083122055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4255 JOHNS CREEK PKWY STE D",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300246122",
            "telephone_number": "404-414-8047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4255 JOHNS CREEK PKWY STE D",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300246122",
            "telephone_number": "404-414-8047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARK SURGICAL SPECIALISTS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-12",
        "last_updated": "2018-10-01",
        "status": "A",
        "authorized_official_last_name": "MCDONALD",
        "authorized_official_first_name": "TERRI",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "404-414-8047"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "GA",
            "license": "32801",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deepika Pandit
• Joseph Landon Pangburn
• Sylvain Panu, LAPC
• Paraclete Counseling Center, Inc
• Kimberly Paris, APRN, FNP-BC
• Alexander D. Park, M.D.
• Eunse Park, PT, PHD
• Grace Park, MD
• Hayeon Park, NP-C
• Hyeon Hui Park, APRN, FNP-BC

• Specialist in Suwanee, GA
• Providers in Suwanee, GA by specialty
• Specialist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.