Park Plastic Surgery, P.a.

Primary specialty

SpecialistTaxonomy code 174400000X

License

36793 Issued in NC

Legal business name

PARK PLASTIC SURGERY, P.A.

Practice address

4008 Capital Dr
Rocky Mount, NC 27804-3123

Phone

(252) 937-5003

Fax

(252) 937-3020

NPI assigned

Sep 26, 2006

Last updated

Jan 7, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Frederick K. Park, MDNPI 1407964547

Title

Owner

Phone

(252) 937-5003

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Frederick Kim Park, M.D.

  • Plastic Surgery Physician
  • Rocky Mount, NC
  • NPI 1407964547
  Medicare reassignment Care Compare group NPD Authorized official
• Susan K Everette, RN, MSN, FNP

  • Nurse Practitioner
  • Rocky Mount, NC
  • NPI 1730291923
  Medicare reassignment Care Compare group NPD
• Laura W Bastian

  • Registered Nurse
  • Rocky Mount, NC
  • NPI 1114706686
  NPD

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1767744000000",
    "number": "1265533806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13219",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277093219",
            "telephone_number": "252-937-5003",
            "fax_number": "252-937-3020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4008 CAPITAL DR",
            "city": "ROCKY MOUNT",
            "state": "NC",
            "postal_code": "278043123",
            "telephone_number": "252-937-5003",
            "fax_number": "252-937-3020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARK PLASTIC SURGERY, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-26",
        "last_updated": "2026-01-07",
        "certification_date": "2026-01-07",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "FREDERICK",
        "authorized_official_middle_name": "K.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "252-937-5003",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NC",
            "license": "36793",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1265533806",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Aaron Pait
• Aurora K Pajeau, MD
• Carol Gibbons Paluch, CRNA
• Pam Specialty Hospital of Rocky Mount LLC (PAM Specialty Hospital of Rocky Mount)
• Brett Paranzino
• Frederick Kim Park, M.D.
• Irfan Umer Parkar, M.D.
• Destiny Parker-Nixon, DPT, PT
• Ashley Parker
• Dana Parker

• Specialist in Rocky Mount, NC
• Providers in Rocky Mount, NC by specialty
• Specialist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.