Bobbi Park, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

A121789 Issued in IA

Practice address

106 19TH Ave Ste 103
Moline, IL 61265-3700

Phone

(309) 779-7050

NPI assigned

Apr 20, 2016

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

Medicare fee-for-service enrollment

Enrolled in IA, IL2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: bobbi.park.1@11922.direct.athenahealth.com

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.

• Amana Medical Care, Inc.

  • Urgent Care Clinic/Center
  • Davenport, IA
  • NPI 1306235072
  Medicare reassignment
• Digestive Disease Specialists PC

  • Gastroenterology Physician
  • Moline, IL
  • NPI 1891077160
  NPD
• Kidney Specialists, PC

  • Nephrology Physician
  • Bettendorf, IA
  • NPI 1598935488
  NPD (past)

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

{
    "created_epoch": "1461110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461110400000",
    "number": "1194179705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 19TH AVE STE 103",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612653700",
            "telephone_number": "309-779-7050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 19TH AVE STE 103",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612653700",
            "telephone_number": "309-779-7050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "BOBBI",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-20",
        "last_updated": "2016-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IA",
            "license": "A121789",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maria Paniamogan, PA
• Pamela C. Papas-Corden, M.D.
• Ancilla Louise Parducci
• Alex J Pareigis, MD
• Elizabeth Ruta Pareigis, M.D.
• Parkway View Family Dentistry LTD
• Jennifer Julianne Fluga Parsons
• Lauren Pass, DDS
• Ryane M Passno, AGACNP-BC APN, PNP-B
• Patel-Shah Dental PLLC

• Family Nurse Practitioner in Moline, IL
• Providers in Moline, IL by specialty
• Family Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.