Jandyll Park

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

220 N Plaza Blvd
Chillicothe, OH 45601-1787

Phone

(740) 851-6493

Fax

(740) 851-6495

NPI assigned

Aug 26, 2020

Sex

Female

Sole proprietor

Yes

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

Practice roles

Interoperability endpoints

• FHIR API: https://api.qualifacts.org/api/fhir/pathihc/r4/

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.

• Phoenix Group Home, LLC

  • Community/Behavioral Health Agency
  • Portsmouth, OH
  • NPI 1083146013
  NPD (past)
• Phoenix Group Home, LLC

  • Substance Abuse Rehabilitation Facility
  • Cincinnati, OH
  • NPI 1336654854
  NPD (past)

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

{
    "created_epoch": "1598400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598400000000",
    "number": "1316550700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "580 HAPPY HOLLOW RD",
            "city": "CHILLICOTHE",
            "state": "OH",
            "postal_code": "456018551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 N PLAZA BLVD",
            "city": "CHILLICOTHE",
            "state": "OH",
            "postal_code": "456011787",
            "telephone_number": "740-851-6493",
            "fax_number": "740-851-6495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "JANDYLL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-26",
        "last_updated": "2020-08-26",
        "certification_date": "2020-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca Leigh Thompson Pareja, MD
• Kevin Matthew Pargeter, D.O.
• Indravadan Kantilal Parikh, M.D., F.A.C.P.
• Brittany Park
• Gwendolyn J Park, RN
• Jerri A Park, BSN,RN
• Ji Yeong Park, PHARMD
• Matthew Park, CRNA
• Amy L Parke, FNP
• Kathryn Parker

• Case Manager/Care Coordinator in Chillicothe, OH
• Providers in Chillicothe, OH by specialty
• Case Manager/Care Coordinator in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2020; 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.