Active NPI
Eden Parks, RN, LPC
- Registered Nurse
- Dallas, GA
National Provider Identifier
1306203179
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- RN309891
- Practice address
- 21 Crescent Chase
Dallas, GA 30157-5729 - Phone
- (404) 399-7480
- NPI assigned
- Jan 25, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | LPC008454 | GA | |
| Registered Nurse | 163W00000X | RN309891 | GA | Primary |
Addresses
Primary practice location
21 Crescent Chase
Dallas, GA 30157-5729
Mailing address
21 Crescent Chase
Dallas, GA 30157-5729
Phone (404) 399-7480
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)
- Not enrolled
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LPC008454 | GA | MD | Professional Counselor |
| RN309891 | GA | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1453680000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1654819200000",
"number": "1306203179",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21 CRESCENT CHASE",
"city": "DALLAS",
"state": "GA",
"postal_code": "301575729",
"telephone_number": "404-399-7480"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21 CRESCENT CHASE",
"city": "DALLAS",
"state": "GA",
"postal_code": "301575729",
"telephone_number": "404-399-7480"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PARKS",
"first_name": "EDEN",
"credential": "RN, LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-01-25",
"last_updated": "2022-06-10",
"certification_date": "2022-06-10",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "GA",
"license": "LPC008454",
"primary": false
},
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "GA",
"license": "RN309891",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dallas, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.