Kwangme Park

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

5781 Issued in OH

Practice address

3138 Laura LN
Westlake, OH 44145-5524

Phone

(216) 544-1715

NPI assigned

Apr 24, 2021

Last updated

Apr 24, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Medicare enrollment (NPD)

Enrolled

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Full Life Mobile Therapy LLC

  • Occupational Therapist
  • Westlake, OH
  • NPI 1295318897
  Authorized official Same address or phone

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

{
    "created_epoch": "1619222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619222400000",
    "number": "1437731916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3138 LAURA LN",
            "city": "WESTLAKE",
            "state": "OH",
            "postal_code": "441455524",
            "telephone_number": "216-544-1715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3138 LAURA LN",
            "city": "WESTLAKE",
            "state": "OH",
            "postal_code": "441455524",
            "telephone_number": "216-544-1715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "KWANGME",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-24",
        "last_updated": "2021-04-24",
        "certification_date": "2021-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "OH",
            "license": "5781",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Robert Paradise, M.D.
• Paramount Chiropractic
• Antonios Paras, MD
• Christie Pargas
• Ashley Parish, CNM
• Kristina Parr, CRNA
• George Peter Parras, M.D.
• Passport Health Holdings, LLC
• Olivia Pastor
• James Dallas Pate, BCNP

• Occupational Therapist in Westlake, OH
• Providers in Westlake, OH by specialty
• Occupational Therapist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.