David Park, MD

Primary specialty

Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X

License

036.160411 Issued in IL

Practice address

4800 Maine St
Quincy, IL 62305-5875

Phone

(217) 214-0444

NPI assigned

Apr 19, 2019

Sex

Male

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 IL, MO2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Sports Medicine

Education

Medical College of Wisconsin, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Blessing HospitalGroup PAC ID 3072422534, 414 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Blessing Hospital Hospital, Quincy, IL, CCN 140015

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: davidpark@blessinghs.allscriptsdirect.net
• FHIR API: https://fhir.blessinghospital.com/R4/open-Prod

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.

• Blessing Hospital

  • Multi-Specialty Clinic/Center
  • Quincy, IL
  • NPI 1114471737

  MO

  Medicare reassignment Care Compare group NPD
• Quincy Clinical Laboratory Services SC

  • Anatomic Pathology & Clinical Pathology Physician
  • Quincy, IL
  • NPI 1114773272
  NPD
• West Central Pathology Specialists, S.C.

  • Anatomic Pathology & Clinical Pathology Physician
  • Quincy, IL
  • NPI 1083895452
  NPD
• Blessing Hospital

  • Rural Health Clinic/Center
  • Monroe City, MO
  • NPI 1013683507
  NPD
• Blessing Hospital

  • Emergency Medical Services (Emergency Medicine) Physician
  • Quincy, IL
  • NPI 1558489021
  NPD (past)

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

• Blessing Hospital

  • Nurse Practitioner
  • Quincy, IL
  • NPI 1417204827

  Hospital

  Care Compare affiliation
• Blessing Hospital

  • General Acute Care Hospital
  • Quincy, IL
  • NPI 1760571699
  Care Compare affiliation

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

{
    "created_epoch": "1555632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720051200000",
    "number": "1356904866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "612 N 11TH ST",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623012662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4800 MAINE ST",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623055875",
            "telephone_number": "217-214-0444"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "612 N 11th St",
            "address_purpose": "LOCATION",
            "city": "Quincy",
            "state": "IL",
            "postal_code": "623012662",
            "country_code": "US",
            "telephone_number": "217-224-9484",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PARK",
        "first_name": "DAVID",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-19",
        "last_updated": "2024-07-04",
        "certification_date": "2024-07-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "IL",
            "license": "036.160411",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patricia A. Pahlmann, PT
• Stefan Cole Paic, PHARM.D
• Malia Shae Pak, BSEXSC
• Behnam Panbehi, M.D.
• Miguel Agustin Pardinas Gutierrez, MD
• Lucy Charlene Parker-Barnes, PHD, LPC, LCPC, NCC
• Carrie Ellen Parker
• Christopher Parker, LCPC
• Samantha Von Parker
• Jeanna B. Parkhill, LCPC

• Sports Medicine (Family Medicine) Physician in Quincy, IL
• Providers in Quincy, IL by specialty
• Sports Medicine (Family Medicine) Physician in Illinois

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