Active NPI
Karyn Russell Parks, OTR
- Occupational Therapist
- Ormond Beach, FL
National Provider Identifier
1154445583
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OT 12168
- Practice address
- 170 N Center St
Ormond Beach, FL 32174-5186 - Phone
- (386) 672-7113
- NPI assigned
- Mar 19, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | OT 12168 | FL | Primary |
Addresses
Primary practice location
170 N Center St
Ormond Beach, FL 32174-5186
Mailing address
316 Perfect Dr
Daytona Beach, FL 32124-2067
Phone (603) 682-3087
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OT 12168 | FL | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174262400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1154445583",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "316 PERFECT DR",
"city": "DAYTONA BEACH",
"state": "FL",
"postal_code": "321242067",
"telephone_number": "603-682-3087"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "170 N CENTER ST",
"city": "ORMOND BEACH",
"state": "FL",
"postal_code": "321745186",
"telephone_number": "386-672-7113"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PARKS",
"first_name": "KARYN",
"middle_name": "RUSSELL",
"credential": "OTR",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-19",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "FL",
"license": "OT 12168",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ormond Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.