Carol A. Park, LPC, RD, LD, CEDRED

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

DT02795 Issued in TX

Practice address

1702 N. Collins Blvd. Ste 207
Richardson, TX 75080-3550

Phone

(469) 324-9744

Fax

(972) 591-2943

NPI assigned

Nov 1, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598227200000",
    "number": "1205913845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1702 N COLLINS BLVD STE 207",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750803550",
            "telephone_number": "469-324-9744",
            "fax_number": "972-671-2087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1702 N. COLLINS BLVD. STE 207",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750803550",
            "telephone_number": "469-324-9744",
            "fax_number": "972-591-2943"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "CAROL",
        "middle_name": "A.",
        "credential": "LPC, RD, LD, CEDRED",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-01",
        "last_updated": "2020-08-24",
        "certification_date": "2020-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "66588",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "66588",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "TX",
            "license": "DT02795",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paragon Pain & Rehabilitation PLLC
• Kerry Pardue, CRPH
• Maria Estela Parides, MA
• Biren Parikh, MD
• Christel Parish, D.C.
• Issa Park, LMHC
• Jaehong Park
• Jey Park, OTD, OTR/L
• Juan Park, D.C.
• Jun Hee Park, DDS

• Registered Dietitian in Richardson, TX
• Providers in Richardson, TX by specialty
• Registered Dietitian in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2020; 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.