NPIMap

Organization Active NPI

Neurological Clinic, SC

  • Clinic/Center
  • Annandale, VA
National Provider Identifier
1144879206
Registry record updated Sep 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
NEUROLOGICAL CLINIC, SC
Practice address
7700 Little River Tpke Ste 605
Annandale, VA 22003-2400
Phone
(571) 620-7159
Fax
(571) 620-7571
NPI assigned
Sep 10, 2019
Last updated
Sep 10, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2019

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

Authorized official

Name
Dr. Byung H. Park, MD
Title
President
Phone
(262) 880-5525

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

7700 Little River Tpke Ste 605
Annandale, VA 22003-2400

Mailing address

5525 Green Bay Rd
Kenosha, WI 53144-3737
Phone (262) 657-2060

National Provider Directory

National Provider Directory

Locations

10400 75th St
#301
Kenosha, WI 53142
Phone (262) 637-6106

5525 Green Bay Rd
Kenosha, WI 53144

8500 75th St
Ste 104
Kenosha, WI 53142
Phone (262) 637-6106

9916 75th St
#100
Kenosha, WI 53142
Phone (262) 637-6106

9916 75th St
Ste 100
Kenosha, WI 53142
Phone (262) 637-6106

Practitioners & affiliated clinicians

Practitioners 14

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.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1568073600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1568073600000",
    "number": "1144879206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5525 GREEN BAY RD",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531443737",
            "telephone_number": "262-657-2060",
            "fax_number": "262-657-2069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7700 LITTLE RIVER TPKE STE 605",
            "city": "ANNANDALE",
            "state": "VA",
            "postal_code": "220032400",
            "telephone_number": "571-620-7159",
            "fax_number": "571-620-7571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEUROLOGICAL CLINIC, SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-10",
        "last_updated": "2019-09-10",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "BYUNG",
        "authorized_official_middle_name": "H.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "262-880-5525",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Annandale, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2019; 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.