Christopher Park

Primary specialty

Orthopedic Physical TherapistTaxonomy code 2251X0800X

License

PT025677 Issued in PA

Practice address

600 Washington Ave
Suite 18U-a
Philadelphia, PA 19147-4836

Phone

(215) 678-4620

NPI assigned

Dec 1, 2016

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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.

• Optimal Physical Therapy Gym, LLC

  • Physical Therapist
  • Philadelphia, PA
  • NPI 1053662197
  NPD (past)

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

{
    "created_epoch": "1480550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480550400000",
    "number": "1467995985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11805 AUDUBON AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191162416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 WASHINGTON AVE",
            "address_2": "SUITE 18U-A",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191474836",
            "telephone_number": "215-678-4620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "CHRISTOPHER",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-12-01",
        "last_updated": "2016-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "PA",
            "license": "PT025677",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Albert Park, DPT
• Alice Soo Park, NP
• Angelina Park
• Chan H Park, MD
• Chantel Park
• Claire Park
• Daniel Sungjoo Park, MD, PHD
• Debbie Park, DPM
• Ella Park
• Eugene Park, M.D.

• Orthopedic Physical Therapist in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Orthopedic Physical Therapist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2016; 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.