Individual provider Active NPI

Erica Francesca Lari Parks, PHD, PA-C

  • Medical Physician Assistant
  • Gainesville, GA
National Provider Identifier
1255844643
Registry record updated Nov 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
10304 Issued in GA
Practice address
1631 Atlanta Hwy
Gainesville, GA 30504-5942
Phone
(770) 718-1517
NPI assigned
Nov 8, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Medical Physician Assistant 363AM0700X 10304 GA Primary

Addresses

Primary practice location

1631 Atlanta Hwy
Gainesville, GA 30504-5942

Mailing address

1631 Atlanta Hwy
Gainesville, GA 30504-5942
Phone (770) 718-1517

Other practice location 1

2185 Pacheco St
Concord, CA 94520-2309
Phone (925) 676-0300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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

Enrollment IDStateProvider typePAC IDDetails
I20180612000957 CA Order and Referring Only - Physician Assistant 3779838982

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
10304GAMDMedical Physician Assistant

Interoperability endpoints

  • Direct secure messaging: erica.parkspa.p1@direct.ppnorcal.nextgenshare.com

NPI Registry JSON

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

{
    "created_epoch": "1510099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669680000000",
    "number": "1255844643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1631 ATLANTA HWY",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305045942",
            "telephone_number": "770-718-1517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1631 ATLANTA HWY",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305045942",
            "telephone_number": "770-718-1517"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2185 Pacheco St",
            "address_purpose": "LOCATION",
            "city": "Concord",
            "state": "CA",
            "postal_code": "945202309",
            "country_code": "US",
            "telephone_number": "925-676-0300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PARKS",
        "first_name": "ERICA",
        "middle_name": "FRANCESCA LARI",
        "credential": "PHD, PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-08",
        "last_updated": "2022-11-29",
        "certification_date": "2022-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "GA",
            "license": "10304",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, GA

Sources for this page

Verify at the official NPI Registry.