Connie Parks

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

CONNIE PARKS

Doing business as

Bio Medical Laboratory

Practice address

4504 Logan Way
Hubbard, OH 44425-3345

Phone

(330) 759-8334

Fax

(330) 759-0780

NPI assigned

May 9, 2007

Last updated

Mar 5, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kristen Zocco

Title

Vice President

Phone

(330) 759-8334

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Bio Medical Laboratory Doing business as

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Locations

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

{
    "created_epoch": "1178668800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1362441600000",
    "number": "1184838443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4504 LOGAN WAY",
            "city": "HUBBARD",
            "state": "OH",
            "postal_code": "444253345",
            "telephone_number": "330-759-8334",
            "fax_number": "330-759-0780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4504 LOGAN WAY",
            "city": "HUBBARD",
            "state": "OH",
            "postal_code": "444253345",
            "telephone_number": "330-759-8334",
            "fax_number": "330-759-0780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONNIE PARKS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-09",
        "last_updated": "2013-03-05",
        "status": "A",
        "authorized_official_last_name": "ZOCCO",
        "authorized_official_first_name": "KRISTEN",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "330-759-8334"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0450266",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bio Medical Laboratory",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Clinical Medical Laboratory in Hubbard, OH
• Providers in Hubbard, OH by specialty
• Clinical Medical Laboratory in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.