NPIMap

Individual provider Active NPI

Kristen Park, MD

  • Neurology with Special Qualifications in Child Neurology Physician
  • Aurora, CO
National Provider Identifier
1194880328
Registry record updated Jul 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology with Special Qualifications in Child Neurology PhysicianTaxonomy code 2084N0402X
License
46952 Issued in CO
Practice address
13123 E 16TH Ave
Aurora, CO 80045-7106
Phone
(720) 777-1234
Fax
(720) 777-7285
NPI assigned
Dec 27, 2006
Last updated
Jul 2, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology with Special Qualifications in Child Neurology Physician 2084N0402X 46952 CO Primary

Addresses

Primary practice location

13123 E 16TH Ave
Aurora, CO 80045-7106

Mailing address

PO Box 110429
Aurora, CO 80042-0429
Phone (303) 493-7000

Other identifiers 1

IdentifierTypeStateIssuer
23573571MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT, CO2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20100504000659 MT Practitioner - Pediatric Medicine 4183752611 Reassigns benefits to 1 organization
I20110329000237 CO Practitioner - EpileptologistsPractitioner - NeurologyPractitioner - Pediatric Medicine 4183752611 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
46952COMDNeurology with Special Qualifications in Child Neurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Billings Clinic CurrentSince Dec 20, 2022 Accepting new patients
Children's Hospital Colorado Current Accepting new patients
University Physicians, Incorporated CurrentSince Dec 1, 2010 Accepting new patients
Billings Clinic Current Accepting new patients
Billings Clinic CurrentSince Dec 20, 2022 Accepting new patients
Denver Health and Hospital Authority CurrentSince Jun 13, 2025 Accepting new patients
Denver Health and Hospital Authority CurrentSince Jun 13, 2025 Accepting new patients
University Physicians Incorporated Pediatrics CurrentSince Dec 1, 2010 Accepting new patients
Billings Clinic Past Accepting new patients
Children's Hospital Colorado Past Accepting new patients
Denver Health and Hospital Authority Past Accepting new patients

Locations

13123 E 16th Ave
Aurora, CO 80045
Phone (720) 777-3846

13123 E 16th Ave
Ste B130
Aurora, CO 80045

777 Bannock St
Denver, CO 80204

777 Bannock St
Ste MC3450
Denver, CO 80204

Dept 1061
Denver, CO 80256

2800 10th Ave N
Billings, MT 59101
Phone (406) 248-3290

Interoperability endpoints

  • Direct secure messaging: kpark12678@direct.childrenscolorado.org
  • Direct secure messaging: kpark311202@direct.dhha.org

Organizations & group practices 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1167177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372723200000",
    "number": "1194880328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 110429",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800420429",
            "telephone_number": "303-493-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13123 E 16TH AVE",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800457106",
            "telephone_number": "720-777-1234",
            "fax_number": "720-777-7285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "KRISTEN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-27",
        "last_updated": "2013-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "CO",
            "license": "46952",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "23573571",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, CO

Sources for this page

Verify at the official NPI Registry.