Active NPI
Youn W Park, MD
- Otolaryngology Physician
- Barberton, OH
National Provider Identifier
1265429161
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Otolaryngology Physician
- License
- 35043203
- Practice address
- 105 5TH St SE
Suite 4
Barberton, OH 44203-4255 - Phone
- (330) 753-9763
- Fax
- (330) 753-1086
- NPI assigned
- Oct 5, 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 |
|---|---|---|---|---|
| Otolaryngology Physician | 207Y00000X | 35043203 | OH | Primary |
Addresses
Primary practice location
105 5TH St SE
Suite 4
Barberton, OH 44203-4255
Mailing address
105 5TH St SE
Suite 4
Barberton, OH 44203-4255
Phone (330) 753-9763
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0398681 | Medicaid | OH | |
| 791043208 | Other | OH | MEDICARE RAILROAD PTAN |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35043203 | OH | MD | Otolaryngology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1128470400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1350259200000",
"number": "1265429161",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "105 5TH ST SE",
"address_2": "SUITE 4",
"city": "BARBERTON",
"state": "OH",
"postal_code": "442034255",
"telephone_number": "330-753-9763",
"fax_number": "330-753-1086"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "105 5TH ST SE",
"address_2": "SUITE 4",
"city": "BARBERTON",
"state": "OH",
"postal_code": "442034255",
"telephone_number": "330-753-9763",
"fax_number": "330-753-1086"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PARK",
"first_name": "YOUN",
"middle_name": "W",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-10-05",
"last_updated": "2012-10-15",
"status": "A"
},
"taxonomies": [
{
"code": "207Y00000X",
"taxonomy_group": "",
"desc": "Otolaryngology",
"state": "OH",
"license": "35043203",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0398681",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RAILROAD PTAN",
"identifier": "791043208",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Barberton, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.