George S Park, PH.D., M.P.

Primary specialty

Prescribing (Medical) PsychologistTaxonomy code 103TP0016X

License

MP0983 Issued in LA

Practice address

2285 Benton Rd BLDG 3
Suite 401
Bossier City, LA 71111-7933

Phone

(318) 415-8755

Fax

(318) 746-8565

NPI assigned

Jun 8, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in LA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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.

• Argosy Mental Health Services P a

  • Clinical Psychologist
  • Lufkin, TX
  • NPI 1801833298
  NPD (past) Authorized official
• George S. Park, PHD., MP., a Psychology Corporation

  • Prescribing (Medical) Psychologist
  • Bossier City, LA
  • NPI 1790297182

  Prescribing (Medical)

  NPD (past)
• Everhealth ,PLLC

  • Psychiatry Physician
  • Tomball, TX
  • NPI 1306872791

  Psychologist

  NPD (past)

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452470400000",
    "number": "1437199031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5478",
            "city": "BOSSIER CITY",
            "state": "LA",
            "postal_code": "711715478",
            "telephone_number": "318-415-8755",
            "fax_number": "318-746-8565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2285 BENTON RD BLDG 3",
            "address_2": "SUITE 401",
            "city": "BOSSIER CITY",
            "state": "LA",
            "postal_code": "711117933",
            "telephone_number": "318-415-8755",
            "fax_number": "318-746-8565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "GEORGE",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "PH.D., M.P.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-08",
        "last_updated": "2016-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TP0016X",
            "taxonomy_group": "",
            "desc": "Psychologist, Prescribing (Medical)",
            "state": "LA",
            "license": "MP0983",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "314936",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kimberly Denise Pair, PA-C
• Briana Palmer, PLPC
• Kirsten Palmer, RPH
• Thomas Ryan Palmer, M.D.
• Kiah Danae Pannebaker, RBT
• Chelsea Parker, MCD, CCC-SLP
• Milford Earl Parker Sr.
• Christine K Pastilong, O.D.
• Sarah Patterson
• Jennifer Bond Patton, NP

• All providers in Bossier City, LA
• Prescribing (Medical) Psychologist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2016; 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.