Jina Park, AGPCNP-C

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

AP132571 Issued in TX

Practice address

6363 N State Highway 161 Ste 100
Irving, TX 75038-2239

Phone

(469) 200-3272

NPI assigned

Feb 23, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: jipark@landmarkhealth-direct.org
• Direct secure messaging: jina.park.1@22854.direct.athenahealth.com

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.

• Transitional and Chronic Care PLLC

  • Geriatric Medicine (Internal Medicine) Physician
  • Mesquite, TX
  • NPI 1356935373
  NPD (past)

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

{
    "created_epoch": "1487808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670803200000",
    "number": "1306386354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 N BELT LINE RD STE B",
            "city": "MESQUITE",
            "state": "TX",
            "postal_code": "751491791",
            "telephone_number": "972-329-3500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6363 N STATE HIGHWAY 161 STE 100",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750382239",
            "telephone_number": "469-200-3272"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3600 Veronica Dr",
            "address_purpose": "LOCATION",
            "city": "Flower Mound",
            "state": "TX",
            "postal_code": "750220977",
            "country_code": "US",
            "telephone_number": "520-609-5058",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1601 N Belt Line Rd Ste B",
            "address_purpose": "LOCATION",
            "city": "Mesquite",
            "state": "TX",
            "postal_code": "751491791",
            "country_code": "US",
            "telephone_number": "972-329-3500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PARK",
        "first_name": "JINA",
        "credential": "AGPCNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-23",
        "last_updated": "2022-12-12",
        "certification_date": "2022-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "810471",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "TX",
            "license": "AP132571",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maulik Paresh Parikh, M.D.
• Rachana Dixit Parikh, MD
• Shalin Parikh, M.D.
• Park Cities Healthcare, LLC
• David Hwantae Park, O.D.
• Jonathan D Park, O.D.
• Lillian Park, LPC
• Simon Sangbeom Park
• Yeon Joon Park, PHARMD
• Parker and Garcia Dentistry Partnership

• Adult Health Nurse Practitioner in Irving, TX
• Providers in Irving, TX by specialty
• Adult Health Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2022; 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.