Active NPI
Kyeeun Park
- Interventional Cardiology Physician
- Birmingham, AL
National Provider Identifier
1336766542
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Interventional Cardiology Physician
- License
- 53881
- Practice address
- 619 19TH St S
Birmingham, AL 35249-1900 - Phone
- (205) 934-4793
- NPI assigned
- Jul 3, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Interventional Cardiology Physician | 207RI0011X | 53881 | AL | Primary |
Addresses
Primary practice location
619 19TH St S
Birmingham, AL 35249-1900
Mailing address
619 19TH St S
Birmingham, AL 35249-1900
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230623000327 | FL | Order and Referring Only - Cardiovascular Disease (Cardiology) | 2668830647 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1593734400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1782086400000",
"number": "1336766542",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "619 19TH ST S",
"city": "BIRMINGHAM",
"state": "AL",
"postal_code": "352491900"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "619 19TH ST S",
"city": "BIRMINGHAM",
"state": "AL",
"postal_code": "352491900",
"telephone_number": "205-934-4793"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PARK",
"first_name": "KYEEUN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-07-03",
"last_updated": "2026-06-22",
"certification_date": "2026-06-22",
"status": "A"
},
"taxonomies": [
{
"code": "207RI0011X",
"taxonomy_group": "",
"desc": "Internal Medicine, Interventional Cardiology",
"state": "AL",
"license": "53881",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Birmingham, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2026; 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.