Robert G Parke, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

126077 Issued in NY

Practice address

4101 Medical Center Dr
Fayetteville, NY 13066-6610

Phone

(315) 637-7878

Fax

(315) 329-7825

NPI assigned

Mar 29, 2006

Last updated

Nov 23, 2011By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1143590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1322006400000",
    "number": "1255392270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4101 MEDICAL CENTER DR",
            "city": "FAYETTEVILLE",
            "state": "NY",
            "postal_code": "130666600",
            "telephone_number": "315-637-7878",
            "fax_number": "315-329-7825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4101 MEDICAL CENTER DR",
            "city": "FAYETTEVILLE",
            "state": "NY",
            "postal_code": "130666610",
            "telephone_number": "315-637-7878",
            "fax_number": "315-329-7825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARKE",
        "first_name": "ROBERT",
        "middle_name": "G",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-29",
        "last_updated": "2011-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "126077",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00561293",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John J Osborne, LCSW
• Adam W Paddock, PA-C
• Painted Post, LLC (East Side Manor)
• Lindsey M Painter
• Sally A Palmer, NP
• Tamra A. Parker, LCSW-R
• Priya Prakash Patel, PA
• Paula Pons Physician LLC
• Nicolas Pauly, NPP
• Samuel B Pearlstein, DPM

• Family Medicine Physician in Fayetteville, NY
• Providers in Fayetteville, NY by specialty
• Family Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2011; 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.