Active NPI
Kee Jong Park, M.D.
- Pediatrics Physician
- Glen Burnie, MD
National Provider Identifier
1215927280
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- D0018934
- Practice address
- 7845 Oakwood Rd
Suite 308
Glen Burnie, MD 21061-4280 - Phone
- (410) 760-8131
- Fax
- (410) 760-8130
- NPI assigned
- Oct 21, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | D0018934 | MD | Primary |
Addresses
Primary practice location
7845 Oakwood Rd
Suite 308
Glen Burnie, MD 21061-4280
Mailing address
6196 Devon Dr
Columbia, MD 21044-3821
Phone (410) 992-5963
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)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D0018934 | MD | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1129852800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1215927280",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6196 DEVON DR",
"city": "COLUMBIA",
"state": "MD",
"postal_code": "210443821",
"telephone_number": "410-992-5963",
"fax_number": "410-760-8130"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7845 OAKWOOD RD",
"address_2": "SUITE 308",
"city": "GLEN BURNIE",
"state": "MD",
"postal_code": "210614280",
"telephone_number": "410-760-8131",
"fax_number": "410-760-8130"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PARK",
"first_name": "KEE",
"middle_name": "JONG",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-10-21",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MD",
"license": "D0018934",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Glen Burnie, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.