Jennifer A Park, CNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN254560 Issued in MA

Practice address

360 Merrimack St
Lawrence, MA 01843-1740

Phone

(978) 557-8800

Fax

(978) 557-8633

NPI assigned

Oct 23, 2018

Sex

Female

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 MA, MO, IL3 enrollments

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 3

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner, Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Athol Memorial Hospital Incorporated

  • Critical Access Hospital
  • Athol, MA
  • NPI 1336120047

  Family

  Medicare reassignment NPD
• Henry Heywood Memorial Hospital

  • General Acute Care Hospital
  • Gardner, MA
  • NPI 1205823879

  Family

  Medicare reassignment NPD
• Tauc Il, PC

  • Urgent Care Clinic/Center
  • Collinsville, IL
  • NPI 1487401709
  Medicare reassignment NPD
• Total Access Urgent Care, PC

  • Urgent Care Clinic/Center
  • Saint Louis, MO
  • NPI 1962684886
  Medicare reassignment NPD
• Henry Heywood Memorial Hospital

  • Psychiatric Hospital Unit
  • Gardner, MA
  • NPI 1457685299
  NPD
• Total Access Urgent Care, PC

  • Urgent Care Clinic/Center
  • Saint Louis, MO
  • NPI 1952729402
  NPD

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

{
    "created_epoch": "1540252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540252800000",
    "number": "1265908602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 MERRIMACK ST",
            "city": "LAWRENCE",
            "state": "MA",
            "postal_code": "018431740",
            "telephone_number": "978-557-8800",
            "fax_number": "978-557-8633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 MERRIMACK ST",
            "city": "LAWRENCE",
            "state": "MA",
            "postal_code": "018431740",
            "telephone_number": "978-557-8800",
            "fax_number": "978-557-8633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "JENNIFER",
        "middle_name": "A",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-23",
        "last_updated": "2018-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "RN254560",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joseph Papa, MSW, LICSW,CADC-II
• Thomas P Pappavaselio, M.D.
• Shevaun Marie Parady, RN
• Arianna Parent, PA-C
• Maria J Parham, RD, LDN, CDE
• Cindy L Parra
• Chase Alan Parrish, CRNA
• Partners in Child Development Inc.
• Estelle Elizabeth Passeri, NP
• Hiren Hansraj Patadiya, DMD

• Family Nurse Practitioner in Lawrence, MA
• Providers in Lawrence, MA by specialty
• Family Nurse Practitioner in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2018; 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.