Individual provider Active NPI

Regina Miyoung Park, AGACNP-BC

  • Acute Care Nurse Practitioner
  • Cincinnati, OH
National Provider Identifier
1093170318
Registry record updated Jan 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
APRN.CNP.022288 Issued in OH
Practice address
2139 Auburn Ave
Cincinnati, OH 45219-2906
Phone
(513) 585-4157
Fax
(513) 585-4244
NPI assigned
Dec 31, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X APRN.CNP.022288 OH
Acute Care Nurse Practitioner 363LA2100X APRN.CNP.022288 OH Primary

Addresses

Primary practice location

2139 Auburn Ave
Cincinnati, OH 45219-2906

Mailing address

2139 Auburn Ave # 4-7
Cincinnati, OH 45219-2906
Phone (513) 263-8551

Other identifiers 1

IdentifierTypeStateIssuer
0281246MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181218001443 OH Practitioner - Nurse Practitioner 3577854850 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Vanderbilt University School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Christ Hospital Medical Associates, LLCGroup PAC ID 0244314102, 270 clinicians

Practice addresses (Care Compare)

2139 Auburn Ave
Cincinnati, OH 45219-2906
Phone (513) 585-2000

Hospital & facility affiliations

  • Christ Hospital Hospital, Cincinnati, OH, CCN 360163

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Christ Hospital Medical Associates, LLC Acute Care CurrentSince Feb 1, 2025 Accepting new patients
Trihealth G, LLC CurrentSince Oct 9, 2018 Accepting new patients
Trihealth G LLC CurrentSince Oct 9, 2018 Accepting new patients

Locations

2139 Auburn Ave
Cincinnati, OH 45219
Phone (513) 585-0406

2139 Auburn Ave
#47
Cincinnati, OH 45219

2123 Auburn Ave
#A28
Cincinnati, OH 45219
Phone (513) 585-0523

2123 Auburn Ave
#200
Cincinnati, OH 45219
Phone (513) 321-0833

8240 Northcreek Dr
Cincinnati, OH 45236
Phone (513) 246-5303

2001 Anderson Ferry Rd
Cincinnati, OH 45238
Phone (513) 922-1200

9070 Winton Rd
Cincinnati, OH 45231
Phone (513) 246-2750

Organizations & group practices 3

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1451520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736380800000",
    "number": "1093170318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2139 AUBURN AVE # 4-7",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452192906",
            "telephone_number": "513-263-8551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2139 AUBURN AVE",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452192906",
            "telephone_number": "513-585-4157",
            "fax_number": "513-585-4244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "REGINA",
        "middle_name": "MIYOUNG",
        "credential": "AGACNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-31",
        "last_updated": "2025-01-09",
        "certification_date": "2025-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "OH",
            "license": "APRN.CNP.022288",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "OH",
            "license": "APRN.CNP.022288",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0281246",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.