Kerri Shane Parks, M.D.

Primary specialty

SpecialistTaxonomy code 174400000X

License

A65496 Issued in CA

Practice address

1808 Verdugo Blvd
Suite 208
Glendale, CA 91208-1477

Phone

(818) 952-5322

Fax

(818) 952-7993

NPI assigned

Mar 2, 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 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• DHP of California Medical Group Inc

  • Obstetrics & Gynecology Physician
  • Stockton, CA
  • NPI 1679836084
  Medicare reassignment NPD

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

{
    "created_epoch": "1141257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196985600000",
    "number": "1104893775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1808 VERDUGO BLVD",
            "address_2": "SUITE 208",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912081477",
            "telephone_number": "818-952-5322",
            "fax_number": "818-952-7993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1808 VERDUGO BLVD",
            "address_2": "SUITE 208",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912081477",
            "telephone_number": "818-952-5322",
            "fax_number": "818-952-7993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARKS",
        "first_name": "KERRI",
        "middle_name": "SHANE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-02",
        "last_updated": "2007-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "A65496",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0102260",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Samuel Park, M.D.
• Parker Valley Emergency Physicians Medical Group Inc
• Gregory Stacy Parker II
• Kevin E Parker, LCSW
• Peter J Parker, M.D.
• Paros Home Health Care Inc
• Parpi Mehrabi DPM Podiatry Corporation
• Donald J Parrington, L.M.F.T.
• Saeideh Parrish, PHARMD
• Kevin K Parsamyan, PHARMD

• Specialist in Glendale, CA
• Providers in Glendale, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2007; 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.

Verify at the official NPI Registry.