Robert Allen Parks, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601002251 Issued in MI

Practice address

6300 22 Mile Rd Ste 2
Shelby TWP, MI 48317-2106

Phone

(586) 726-9860

Fax

(586) 726-9537

NPI assigned

Nov 12, 2006

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

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Interoperability endpoints

• Direct secure messaging: rparks@mps1086.srs-direct.com

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

{
    "created_epoch": "1163289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602115200000",
    "number": "1255402384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "298 ANN ST",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481701216",
            "telephone_number": "248-885-2937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6300 22 MILE RD STE 2",
            "city": "SHELBY TWP",
            "state": "MI",
            "postal_code": "483172106",
            "telephone_number": "586-726-9860",
            "fax_number": "586-726-9537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARKS",
        "first_name": "ROBERT",
        "middle_name": "ALLEN",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-12",
        "last_updated": "2020-10-08",
        "certification_date": "2020-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601002251",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physician Assistant in Shelby TWP, MI
• Providers in Shelby TWP, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.