Individual provider Active NPI

Brian Nicholas Parks, D.O.

  • Pain Medicine (Anesthesiology) Physician
  • Victoria, TX
National Provider Identifier
1376869396
Registry record updated Sep 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
Q6891 Issued in TX
Practice address
115 Medical Dr Ste 208
Victoria, TX 77904-3106
Phone
(361) 574-1137
Fax
(361) 574-1186
NPI assigned
Apr 15, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2020

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) Physician 207LP2900X 036141626 IL
Internal Medicine Physician 207R00000X L1761511 MI
Interventional Pain Medicine Physician 208VP0014X 5699 OK
Student in an Organized Health Care Education/Training Program 390200000X
Pain Medicine (Anesthesiology) Physician 207LP2900X Q6891 TX Primary

Addresses

Primary practice location

115 Medical Dr Ste 208
Victoria, TX 77904-3106

Mailing address

115 Medical Dr Ste 208
Victoria, TX 77904-3106
Phone (361) 574-1137

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address brian.parks.1@1902.direct.athenahealth.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, TX2 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

Enrollment IDStateProvider typePAC IDDetails
I20161230000619 IL Practitioner - Anesthesiology 7214169945 Reassigns benefits to 1 organization
I20191231000777 TX Practitioner - Pain ManagementPractitioner - Anesthesiology 7214169945 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pain ManagementAlso: Anesthesiology
Education
At Still University of Health Sciences, College of Osteo Med, Kirksville, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

115 Medical Dr
Victoria, TX 77904-3102
Phone (361) 579-0043

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.18 of 100Reported as apm
Quality
71.02
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
036141626ILMDPain Medicine (Anesthesiology) Physician
Q6891TXMDPain Medicine (Anesthesiology) Physician
L1761511MIMDInternal Medicine Physician
5699OKMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Regional Employee Assistance Program Inc Internal Medicine Current Accepting new patients
Anesthesia Pain Services LLC CurrentSince Jan 1, 2021 Accepting new patients
Regional Employee Assistance Program Inc CurrentSince Jan 1, 2020 Accepting new patients
Regional Employee Assistance Program Inc Pain Medicine CurrentSince Jan 1, 2020 Accepting new patients
Citizens Medical Center County of Victoria Interventional Pain Medicine Past Accepting new patients

Locations

1008 N Main St
Bloomington, IL 61701
Phone (309) 829-5311

1505 Eastland Dr
Bloomington, IL 61701
Phone (309) 663-2100

646 W Pershing Rd
Decatur, IL 62526
Phone (217) 875-0300

1800 E Lake Shore Dr
Decatur, IL 62521
Phone (217) 464-2729

503 N Maple St
Effingham, IL 62401
Phone (217) 342-2121

1602 E Houston St
Ste C
Beeville, TX 78102
Phone (361) 354-2900

2550 N Esplanade St
Cuero, TX 77954
Phone (361) 275-0532

101 Medical Dr
Victoria, TX 77904
Phone (361) 573-6100

2701 Hospital Dr
Victoria, TX 77901
Phone (361) 573-9180

506 E San Antonio St
Victoria, TX 77901
Phone (361) 575-1445

6404 Nursery Dr
Ste 300
Victoria, TX 77904
Phone (361) 570-8311

115 Medical Dr
Ste 208
Victoria, TX 77904
Phone (361) 573-7900

1200 Carl Ramert Dr
Yoakum, TX 77995
Phone (361) 293-2321

Interoperability endpoints

  • Direct secure messaging: bparks719457@directa.mercy.net
  • Direct secure messaging: brian.parks.1@1902.direct.athenahealth.com

Organizations & group practices 5

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.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1271289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599004800000",
    "number": "1376869396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 MEDICAL DR STE 208",
            "city": "VICTORIA",
            "state": "TX",
            "postal_code": "779043106",
            "telephone_number": "361-574-1137",
            "fax_number": "361-574-1186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 MEDICAL DR STE 208",
            "city": "VICTORIA",
            "state": "TX",
            "postal_code": "779043106",
            "telephone_number": "361-574-1137",
            "fax_number": "361-574-1186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARKS",
        "first_name": "BRIAN",
        "middle_name": "NICHOLAS",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-04-15",
        "last_updated": "2020-09-02",
        "certification_date": "2020-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "IL",
            "license": "036141626",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "L1761511",
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "OK",
            "license": "5699",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "TX",
            "license": "Q6891",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "brian.parks.1@1902.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "AMR direct address",
            "address_1": "115 Medical Dr Ste 208",
            "city": "Victoria",
            "state": "TX",
            "country_code": "US",
            "postal_code": "779043106",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Victoria, TX

Sources for this page

Verify at the official NPI Registry.