Kelly Potter Parks, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

C5-0000165 Issued in DE

Practice address

121 S Front St
Seaford, DE 19973-3511

Phone

(302) 629-5030

Fax

(302) 629-5035

NPI assigned

Apr 4, 2007

Last updated

Aug 16, 2007By the provider in NPPES

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 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• The Nemours Foundation

  • Children's Hospital
  • Wilmington, DE
  • NPI 1467505073
  NPD (past)
• The Pediatric & Adolescent Center

  • Specialist
  • Lewes, DE
  • NPI 1548344849
  NPD (past)

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

{
    "created_epoch": "1175644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1187222400000",
    "number": "1184746026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7817 GRACE CIR",
            "city": "SEAFORD",
            "state": "DE",
            "postal_code": "199734337",
            "telephone_number": "302-628-3229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 S FRONT ST",
            "city": "SEAFORD",
            "state": "DE",
            "postal_code": "199733511",
            "telephone_number": "302-629-5030",
            "fax_number": "302-629-5035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARKS",
        "first_name": "KELLY",
        "middle_name": "POTTER",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-04",
        "last_updated": "2007-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "DE",
            "license": "C5-0000165",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE PRESCRIPTION NUMBER",
            "identifier": "RXPA02015",
            "state": "DE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "C5-0000165",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cynthia Foxwell Parker, AUD
• Ellery Leo Parker III, LPCMH
• Teresa Ann Parker, PHARMD
• Brian Parks, PTA
• Cynthia Parks, CADC
• Timothy James Parks, COTA
• Krista Booth Parlier, RN
• Melanie Phy Passwater
• Ian Anton Passwaters, PHARMD
• Jennifer Lee Passwaters, MSN, FNP-C

• Medical Physician Assistant in Seaford, DE
• Providers in Seaford, DE by specialty
• Medical Physician Assistant in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 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.

Verify at the official NPI Registry.