Individual provider Active NPI

Hyeon Hui Park, APRN, FNP-BC

  • Nurse Practitioner
  • Suwanee, GA
National Provider Identifier
1184965188
Registry record updated Dec 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN237528 Issued in GA
Practice address
4310 Johns Creek Pkwy Ste 180
Suwanee, GA 30024-6090
Phone
(678) 957-8908
Fax
(678) 854-8008
NPI assigned
Mar 15, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP123556 TX
Nurse Practitioner 363L00000X RN237528 GA Primary

Addresses

Primary practice location

4310 Johns Creek Pkwy Ste 180
Suwanee, GA 30024-6090

Mailing address

4310 Johns Creek Pkwy Ste 180
Suwanee, GA 30024-6090
Phone (678) 957-8908

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)
Enrolled
Credentials
Master of Science - Nursing

State licenses

LicenseStateTypeSpecialty
2391TXMDFoot & Ankle Surgery Podiatrist
AP123556TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
John Lee MD, LLC CurrentSince Nov 6, 2022 Accepting new patients

Locations

4310 Johns Creek Pkwy
Ste 180
Suwanee, GA 30024
Phone (678) 957-8908

1325 Satellite Blvd NW
Bldg 700
Suwanee, GA 30024
Phone (678) 417-1255

1325 Satellite Blvd NW
Ste 701
Suwanee, GA 30024
Phone (678) 417-1255

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1363305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640131200000",
    "number": "1184965188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4310 JOHNS CREEK PKWY STE 180",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300246090",
            "telephone_number": "678-957-8908",
            "fax_number": "678-854-8008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4310 JOHNS CREEK PKWY STE 180",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300246090",
            "telephone_number": "678-957-8908",
            "fax_number": "678-854-8008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "HYEON HUI",
        "credential": "APRN, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-15",
        "last_updated": "2021-12-22",
        "certification_date": "2021-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP123556",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN237528",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Suwanee, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2021; 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.