Stacy Shoemake Park, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

RPH023837 Issued in GA

Practice address

6435 Bells Ferry Rd
Woodstock, GA 30189-2317

Phone

(770) 926-3626

Fax

(770) 926-3637

NPI assigned

Nov 4, 2020

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

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

{
    "created_epoch": "1604448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604448000000",
    "number": "1346841475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2407 CARINA TER NW",
            "city": "ACWORTH",
            "state": "GA",
            "postal_code": "301013449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6435 BELLS FERRY RD",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301892317",
            "telephone_number": "770-926-3626",
            "fax_number": "770-926-3637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "STACY",
        "middle_name": "SHOEMAKE",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-11-04",
        "last_updated": "2020-11-04",
        "certification_date": "2020-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TN",
            "license": "24738",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "GA",
            "license": "RPH023837",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katryn Marie Parillo, CSA
• Park Pediatric Dentistry of Woodstock, LLC
• Jane Park
• Jihe Park
• Julius Park, D.M.D.
• Anna Parker, PHARMD
• Ashley Nicole Parker, OTD R/L
• Taylor Nicole Parks, MS
• Parkside Optique, LLC
• Christopher Lee Parman, M.D.

• Pharmacist in Woodstock, GA
• Providers in Woodstock, GA by specialty
• Pharmacist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 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.