Grace Park, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

110886 Issued in GA

Practice address

6918 McGinnis Ferry Rd Ste 200
Suwanee, GA 30024-1258

Phone

(770) 622-5758

Fax

(770) 622-5717

NPI assigned

Apr 29, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Childfren'S Medical Group, P.C.

  • Pediatric Adolescent Medicine Physician
  • Atlanta, GA
  • NPI 1497865935
  NPD (past)

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

{
    "created_epoch": "1556496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787097600000",
    "number": "1407410004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6918 MCGINNIS FERRY RD STE 200",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300241258",
            "telephone_number": "770-622-5758",
            "fax_number": "770-622-5717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6918 MCGINNIS FERRY RD STE 200",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300241258",
            "telephone_number": "770-622-5758",
            "fax_number": "770-622-5717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "GRACE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-29",
        "last_updated": "2026-08-19",
        "certification_date": "2026-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "202200704",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "110886",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paraclete Counseling Center, Inc
• Kimberly Paris, APRN, FNP-BC
• Park Surgical Specialists, LLC
• Alexander D. Park, M.D.
• Eunse Park, PT, PHD
• Hayeon Park, NP-C
• Hyeon Hui Park, APRN, FNP-BC
• Julia C Parker, MED, CCC-SLP
• Kristine Peters Parkhurst, MA, CCC-SLP
• Syreeta Deborah Parkinson II

• Pediatrics Physician in Suwanee, GA
• Providers in Suwanee, GA by specialty
• Pediatrics Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 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.

Verify at the official NPI Registry.