Patrick Michael Parks, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0110004352 Issued in VA

Practice address

14521 Forest Rd Ste D
Forest, VA 24551-4079

Phone

(434) 485-8555

Fax

(434) 485-8594

NPI assigned

Nov 9, 2005

Last updated

Oct 20, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: pparks13899@direct.orthovirginia.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Orthovirginia, Inc.

  dba West End Orthopaedic Clinic, Inc

  • Multi-Specialty Clinic/Center
  • North Chesterfield, VA
  • NPI 1265470645
  NPD (past)
• Tuckahoe Orthopaedic Associates, LTD

  • Orthopaedic Surgery Physician
  • Richmond, VA
  • NPI 1578578324
  NPD (past)

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

{
    "created_epoch": "1131494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603152000000",
    "number": "1093796674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2405 ATHERHOLT RD",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "245012184",
            "telephone_number": "434-485-8500",
            "fax_number": "434-485-8599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14521 FOREST RD STE D",
            "city": "FOREST",
            "state": "VA",
            "postal_code": "245514079",
            "telephone_number": "434-485-8555",
            "fax_number": "434-485-8594"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2405 Atherholt Rd",
            "address_purpose": "LOCATION",
            "city": "Lynchburg",
            "state": "VA",
            "postal_code": "245012184",
            "country_code": "US",
            "telephone_number": "434-485-8500",
            "fax_number": "434-485-8599",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PARKS",
        "first_name": "PATRICK",
        "middle_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-09",
        "last_updated": "2020-10-20",
        "certification_date": "2020-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110004352",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pparks13899@direct.orthovirginia.com",
            "affiliation": "N",
            "endpointDescription": "Mr. Parks direct address",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "secure messaging",
            "address_1": "2405 Atherholt Rd",
            "city": "Lynchburg",
            "state": "VA",
            "country_code": "US",
            "postal_code": "245012184",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Orthovirginia, Inc.
• Pacot Builders Inc
• Kathleen A Page, CNM
• Julie Palmer
• Raven Parke, PA-C
• Priyen Patel
• David Robert Paulus, M.D.
• Clifford Ernest Pavalonis
• Adam Pavao, LPC
• Rebecca Marie Pearl, COTA/L

• Physician Assistant in Forest, VA
• Providers in Forest, VA by specialty
• Physician Assistant in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.