Individual provider Active NPI

Hugh Kyle Parks, M.D.

  • Surgery Physician
  • Claxton, GA
National Provider Identifier
1215935606
Registry record updated Mar 23, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
054328 Issued in GA
Practice address
604B E Long St
Claxton, GA 30417-5914
Phone
(912) 739-7710
Fax
(912) 739-7343
NPI assigned
Jul 11, 2005
Last updated
Mar 23, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 054328 GA Primary

Addresses

Primary practice location

604B E Long St
Claxton, GA 30417-5914

Mailing address

200 N River St
Claxton, GA 30417-1659
Phone (912) 739-7710

Other identifiers 1

IdentifierTypeStateIssuer
694559760AMedicaidGA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050727000122 GA Practitioner - General Surgery 6608804117 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Evans Memorial Hospital Surgery Current Accepting new patients
Evans Memorial Hospital, Inc. CurrentSince May 1, 2005 Accepting new patients
Evans Memorial Hospital, Inc. CurrentSince May 1, 2005 Accepting new patients

Locations

200 N River St
Claxton, GA 30417
Phone (912) 739-2611

604 E Long St
#A
Claxton, GA 30417
Phone (912) 355-8000

604A E Long St
Claxton, GA 30417
Phone (912) 739-2611

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/8042/brand/1/csg/1/fhir/r4
  • Direct secure messaging: hugh.parks@evansmemorial.gadirect.net

Organizations & group practices 3

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": "1121040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1269302400000",
    "number": "1215935606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 N RIVER ST",
            "city": "CLAXTON",
            "state": "GA",
            "postal_code": "304171659",
            "telephone_number": "912-739-7710",
            "fax_number": "912-739-7343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "604B E LONG ST",
            "city": "CLAXTON",
            "state": "GA",
            "postal_code": "304175914",
            "telephone_number": "912-739-7710",
            "fax_number": "912-739-7343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARKS",
        "first_name": "HUGH",
        "middle_name": "KYLE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-11",
        "last_updated": "2010-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "GA",
            "license": "054328",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "694559760A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Claxton, GA

Sources for this page

Verify at the official NPI Registry.