Jinson Park

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

R143794 Issued in MD

Practice address

2300 Dulaney Valley Rd
Timonium, MD 21093-2739

Phone

(410) 252-4500

NPI assigned

Dec 14, 2005

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

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 and National Provider Directory roles.

• Home Physicians Baltimore, PC

  • Internal Medicine Physician
  • Baltimore, MD
  • NPI 1952591547
  NPD (past)

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

{
    "created_epoch": "1134518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1224115200000",
    "number": "1194700906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 HEARTHSTONE CT",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214035719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 DULANEY VALLEY RD",
            "city": "TIMONIUM",
            "state": "MD",
            "postal_code": "210932739",
            "telephone_number": "410-252-4500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "JINSON",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-14",
        "last_updated": "2008-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MD",
            "license": "R143794",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Padonia Pediatrics & Medicine, LLC
• Pravalika Palavarapu, LGPC
• Adam S Palmer, PT, DPT
• Jasmine L Pankey
• Vivian Y Pao, MD
• Langley Cameron Parker, MS
• Passport Health Holdings, LLC
• Patel County Dentistry PC
• Ghanshyam G Patel
• Julie Ann Pater, M.S. CCC-SLP

• Gerontology Nurse Practitioner in Timonium, MD
• Providers in Timonium, MD by specialty
• Gerontology Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2008; 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.