Gloria Park, APRN/RN

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

79172 Issued in KS

Practice address

609 Liberty St
Clay Center, KS 67432-1564

Phone

(785) 632-2181

NPI assigned

Jan 30, 2020

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

Enrolled in KS

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Clay County Medical CenterGroup PAC ID 6901959436, 44 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Clay County Medical Center Hospital, Clay Center, KS, CCN 171371

Medicare enrollment (NPD)

Enrolled

Credentials

Registered Nurse

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 and National Provider Directory roles.

• Clay County Medical Center

  • Critical Access Hospital
  • Clay Center, KS
  • NPI 1265485817

  KS, Nurse Practitioner

  Medicare reassignment Care Compare group NPD
• Clay County Medical Center

  • Rural Health Clinic/Center
  • Clay Center, KS
  • NPI 1396108213

  KS

  Medicare reassignment Care Compare group NPD
• Pawnee Mental Health Service, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Manhattan, KS
  • NPI 1275580524

  KS

  Medicare reassignment NPD
• Clay County Medical Center

  • Community Based Hospice Care Agency
  • Clay Center, KS
  • NPI 1073568523
  Care Compare group
• Clay County Medical Center

  • Rural Health Clinic/Center
  • Riley, KS
  • NPI 1487192845
  Care Compare group
• Clay County Medical Center

  • Rural Health Clinic/Center
  • Glasco, KS
  • NPI 1528641321
  Care Compare group
• Clay County Medical Center

  • Rural Health Clinic/Center
  • Linn, KS
  • NPI 1710340690
  Care Compare group
• Clay County Medical Center

  • Rural Health Clinic/Center
  • Clyde, KS
  • NPI 1801259783
  Care Compare group
• Clay County Medical Center

  • Medicare Defined Swing Bed Hospital Unit
  • Clay Center, KS
  • NPI 1841245396
  Care Compare group
• Clay County Medical Center

  • Certified Registered Nurse Anesthetist
  • Clay Center, KS
  • NPI 1134163389

  Nurse Practitioner

  NPD
• Clay County Medical Center

  • Health Service Clinic/Center
  • Clay Center, KS
  • NPI 1205299120
  NPD
• Pawnee Mental Health Service, Inc.

  • Primary Care Clinic/Center
  • Manhattan, KS
  • NPI 1356139158
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Clay County Medical Center

  • Critical Access Hospital
  • Clay Center, KS
  • NPI 1265485817

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1580342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710720000000",
    "number": "1336770205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "609 LIBERTY ST",
            "city": "CLAY CENTER",
            "state": "KS",
            "postal_code": "674321564",
            "telephone_number": "785-632-2181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "609 LIBERTY ST",
            "city": "CLAY CENTER",
            "state": "KS",
            "postal_code": "674321564",
            "telephone_number": "785-632-2181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "GLORIA",
        "name_prefix": "Dr.",
        "credential": "APRN/RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-30",
        "last_updated": "2024-03-18",
        "certification_date": "2024-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "KS",
            "license": "116035",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "KS",
            "license": "79172",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rosemary Neaderhiser, LSCSW
• Don Nebelung, PA-C
• Marian Nelson, M.D.
• Amanda Nye, RBT
• Oaklodges, LLC
• Scott Nolan Patterson, RPH
• Kaylea Pearson, D.C.
• Shawna Pederson, OTR
• Timothy M. Penner, M.D.
• Melissa R Petesch, LSCSW

• All providers in Clay Center, KS
• Psychiatric/Mental Health Nurse Practitioner in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2024; 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.
• 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.