Individual provider Active NPI

Jin Hyung Park, AUD

  • Audiologist
  • Richmond, VA
National Provider Identifier
1326703463
Registry record updated Jun 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
2201001854 Issued in VA
Practice address
1001 E Leigh St FL 14
Richmond, VA 23298-5004
Phone
(804) 828-0431
Fax
(804) 628-0950
NPI assigned
Nov 3, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 5583 OK
Audiologist 231H00000X 2201001854 VA Primary

Addresses

Primary practice location

1001 E Leigh St FL 14
Richmond, VA 23298-5004

Mailing address

724 Bristol Village Dr Apt 206
Midlothian, VA 23114-4636
Phone (918) 805-2583

Other practice location 1

1000 E Broad St
Richmond, VA 23219-1930
Phone (804) 828-2467

Other practice location 2

9109 Stony Point Dr Fl 1
Richmond, VA 23235-1979
Phone (804) 327-8070

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220506002056 VA Practitioner - Qualified Audiologist 8325425671 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MCV Associated PhysiciansGroup PAC ID 4385542117, 1,779 clinicians

Practice addresses (Care Compare)

1001 E Leigh St
Richmond, VA 23298-5004
Phone (804) 828-7929

Merit-based Incentive Payment System (MIPS)

Final score
83.95 of 100Reported as group
Quality
69.91
Promoting interoperability
99
Improvement activities
40
Cost
77.42

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5583OKMDOccupational Therapist
2201001854VAMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
MCV Associated Physicians CurrentSince Jan 18, 2022 Accepting new patients
Vcu Oral-Facial Surgery and Services LLC PastSince Jan 15, 2023 Accepting new patients

Locations

9109 Stony Point Dr
Fl 1
Richmond, VA 23235
Phone (804) 327-8070

1001 E Leigh St
Fl 14
Richmond, VA 23298
Phone (804) 628-4368

1000 E Broad St
Richmond, VA 23219

403 N 11th St
Rm 304
Richmond, VA 23298
Phone (804) 828-0431

1001 E Leigh St
Richmond, VA 23298
Phone (804) 628-7497

9109 Stony Point Dr
Richmond, VA 23235
Phone (804) 827-8000

401 N 11th St
Richmond, VA 23219
Phone (804) 828-4409

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1635897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719273600000",
    "number": "1326703463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "724 BRISTOL VILLAGE DR APT 206",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "231144636",
            "telephone_number": "918-805-2583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 E LEIGH ST FL 14",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232985004",
            "telephone_number": "804-828-0431",
            "fax_number": "804-628-0950"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 E Broad St",
            "address_purpose": "LOCATION",
            "city": "Richmond",
            "state": "VA",
            "postal_code": "232191930",
            "country_code": "US",
            "telephone_number": "804-828-2467",
            "fax_number": "804-827-1560",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9109 Stony Point Dr Fl 1",
            "address_purpose": "LOCATION",
            "city": "Richmond",
            "state": "VA",
            "postal_code": "232351979",
            "country_code": "US",
            "telephone_number": "804-327-8070",
            "fax_number": "804-327-8076",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PARK",
        "first_name": "JIN HYUNG",
        "credential": "AUD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-11-03",
        "last_updated": "2024-06-25",
        "certification_date": "2024-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "OK",
            "license": "5583",
            "primary": false
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "VA",
            "license": "2201001854",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.