Timothy Park, DO

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

5151016962 Issued in MI

Practice address

788 Service Rd # B-401
East Lansing, MI 48824-7013

Phone

(517) 884-2488

NPI assigned

May 16, 2024

Last updated

May 16, 2024By the provider in NPPES

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Osteopathy

State licenses

Interoperability endpoints

• Direct secure messaging: timothy.park.1@25394.direct.athenahealth.com

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

{
    "created_epoch": "1715817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715817600000",
    "number": "1275382723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "788 SERVICE RD # B-401",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488247013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "788 SERVICE RD # B-401",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488247013",
            "telephone_number": "517-884-2488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "TIMOTHY",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-05-16",
        "last_updated": "2024-05-16",
        "certification_date": "2024-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MI",
            "license": "5151016962",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sagar Panthi, M.D.
• Michael Douglas Papson, DPM
• Joshua Macey Paquet, ATC
• Kelly A Paquet, ATC
• Esther Rose Park, M.S.,R.D
• Jerry Deonita Parker Jr.
• Mikala Parker
• Jose Ruben Parra-Cardona, PH.D.
• Jennifer Parsons, FNP-BC
• Mollie Beth Parsons

• Neurology Physician in East Lansing, MI
• Providers in East Lansing, MI by specialty
• Neurology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.