SE-Min John Park, LAC

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

5402000102 Issued in MI

Practice address

44150 W 12 Mile Rd Ste 300
Novi, MI 48377-2649

Phone

(248) 238-8390

NPI assigned

Oct 17, 2018

Sex

Male

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Agape Acupuncture

  • Acupuncturist
  • Livonia, MI
  • NPI 1922656271
  NPD Authorized official
• Agape Acupuncture LLC

  dba Agape Acupuncture of Novi

  • Acupuncturist
  • Novi, MI
  • NPI 1811788755
  NPD Authorized official

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

{
    "created_epoch": "1539734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711065600000",
    "number": "1326514423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44150 W 12 MILE RD STE 300",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483772649",
            "telephone_number": "248-238-8390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44150 W 12 MILE RD STE 300",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483772649",
            "telephone_number": "248-238-8390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "SE-MIN",
        "middle_name": "JOHN",
        "credential": "LAC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-10-17",
        "last_updated": "2024-03-22",
        "certification_date": "2024-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "MI",
            "license": "5402000102",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Park Internal Medicine PC
• Park Place Vein Center
• Sungnan Park-Davis, MD
• Greta Park
• Rosemary Haesung Park, MD
• Donna Marie Parker-Morgan
• Jeanette Parker
• Rachel Parker
• Schaela Parker
• Stephanie Parker

• Acupuncturist in Novi, MI
• Providers in Novi, MI by specialty
• Acupuncturist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 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.