Hyunsoon Edie Park, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

200200581 Issued in NC

Practice address

1100 N College Ave
Veterans Health Care System of the Ozarks
Fayetteville, AR 72703-1944

Phone

(479) 443-4301

NPI assigned

Apr 25, 2006

Sex

Female

Sole proprietor

No

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 TX

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

Specialty

Psychiatry

Education

Brody School of Medicine at East Carolina University, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

DHHS PHS Naihs Chinle Comprehensive Health Care FacilityGroup PAC ID 9436062585, 160 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Chinle Comprehensive Health Care Facility Hospital, Chinle, AZ, CCN 030084

Merit-based Incentive Payment System (MIPS)

Final score

80.86 of 100Reported as group

Quality

61.32

Improvement activities

40

Cost

90.46

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.

• DHHS PHS Naihs Chinle Comprehensive Health Care Facility

  • General Acute Care Hospital
  • Chinle, AZ
  • NPI 1508800129

  TX

  Medicare reassignment Care Compare group NPD
• DHHS PHS Naihs Chinle Comprehensive Health Care Facility

  • General Acute Care Hospital
  • Tsaile, AZ
  • NPI 1538185715
  NPD
• Hospice & Palliative Care of the Blue Ridge Inc

  • Exclusive Provider Organization
  • Spruce Pine, NC
  • NPI 1023084399
  NPD (past)
• New Vistas-Mountain Laurel, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Hendersonville, NC
  • NPI 1710937396
  NPD (past)

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

{
    "created_epoch": "1145923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1253664000000",
    "number": "1467418764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4105 TREETOPS CIR",
            "city": "WINTERVILLE",
            "state": "NC",
            "postal_code": "285909221",
            "telephone_number": "252-412-0542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 N COLLEGE AVE",
            "address_2": "VETERANS HEALTH CARE SYSTEM OF THE OZARKS",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727031944",
            "telephone_number": "479-443-4301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "HYUNSOON",
        "middle_name": "EDIE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-25",
        "last_updated": "2009-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NC",
            "license": "200200581",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5900452",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Paige M Panter
• Deepak K Parashara, M.D.
• Karen Leigh Pardue, LCSW
• Gordon R Parham, MD
• Nathanael David Paris
• Jong Park, MD
• Josephine H. Park, M.D.
• Parker Psychology & Counseling Associates
• Alison Parker, M.S., CFY-SLP
• Anna Parker, PHARMD

• Psychiatry Physician in Fayetteville, AR
• Providers in Fayetteville, AR by specialty
• Psychiatry Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2009; 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.