Soon Sik Park

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

U02475 Issued in MD

Practice address

3344 Saint Johns LN
Ellicott City, MD 21042-2601

Phone

(301) 814-1211

Fax

(240) 720-4900

NPI assigned

Jan 20, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Specialty

Undefined Non-Physician Type (Specify)

Education

Other, 2013

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Shalom Eastern Medicine,Inc

  dba Shalom Acupuncture & Wellness

  • Acupuncturist
  • Ellicott City, MD
  • NPI 1366052664
  NPD Authorized official

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

{
    "created_epoch": "1547942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596412800000",
    "number": "1437623725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3344 SAINT JOHNS LN",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210422601",
            "telephone_number": "301-814-1211",
            "fax_number": "240-720-4900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3344 SAINT JOHNS LN",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210422601",
            "telephone_number": "301-814-1211",
            "fax_number": "240-720-4900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "SOON",
        "middle_name": "SIK",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-01-20",
        "last_updated": "2020-08-03",
        "certification_date": "2020-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "MD",
            "license": "U02475",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paragon Integrative Health, LLC
• Chan Park
• Chungheon Park
• Grace Park
• Jake J Park, D.C.
• Soongil Shannen Park, LAC
• Sung Mi Park, L.AC
• Macqueen Parker, LCSW-C
• Parmar Primary Care Medicine LLC (Ellicott City Primary Care Medicine)
• Carole A. Parnes, M.D.

• Acupuncturist in Ellicott City, MD
• Providers in Ellicott City, MD by specialty
• Acupuncturist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2020; 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.