Active NPI
Madelon Jean Parks, PH.D.
- Psychologist
- Fletcher, NC
National Provider Identifier
1417918285
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 2915
- Practice address
- 455 Concord Rd
Fletcher, NC 28732-9734 - Phone
- (828) 329-8306
- Fax
- (828) 258-3831
- NPI assigned
- Mar 31, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 2915 | NC | |
| Psychologist | 103T00000X | 2915 | NC | Primary |
Addresses
Primary practice location
455 Concord Rd
Fletcher, NC 28732-9734
Mailing address
455 Concord Rd
Fletcher, NC 28732-9734
Phone (828) 329-8306
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 108059 | Other | NC | VALUE OPTIONS |
| U02489965 | Other | NC | CIGNA BEHAVIORAL |
| 6000594 | Medicaid | NC | |
| C8053 | Other | NC | MEDCOST |
| 045YF | Other | NC | BCBSNC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2915 | NC | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1143763200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1306281600000",
"number": "1417918285",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "455 CONCORD RD",
"city": "FLETCHER",
"state": "NC",
"postal_code": "287329734",
"telephone_number": "828-329-8306",
"fax_number": "828-258-3831"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "455 CONCORD RD",
"city": "FLETCHER",
"state": "NC",
"postal_code": "287329734",
"telephone_number": "828-329-8306",
"fax_number": "828-258-3831"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PARKS",
"first_name": "MADELON",
"middle_name": "JEAN",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-03-31",
"last_updated": "2011-05-25",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NC",
"license": "2915",
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NC",
"license": "2915",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VALUE OPTIONS",
"identifier": "108059",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA BEHAVIORAL",
"identifier": "U02489965",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "6000594",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDCOST",
"identifier": "C8053",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBSNC",
"identifier": "045YF",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fletcher, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.