Jamie Park, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

26NR00439400 Issued in NJ

Practice address

200 Grand Ave Ste 203
Englewood, NJ 07631-4363

Phone

(201) 588-0444

NPI assigned

Jun 4, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1275609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482278400000",
    "number": "1477873107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 CAMPBELL AVE",
            "city": "AIRMONT",
            "state": "NY",
            "postal_code": "109016302",
            "telephone_number": "845-538-3767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 GRAND AVE STE 203",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "076314363",
            "telephone_number": "201-588-0444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "JAMIE",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-06-04",
        "last_updated": "2016-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "02200576964",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NJ",
            "license": "26NR00439400",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F337600-1",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shwetambara Parakh, MD, FACS
• Parea Medical Goods
• Domenica Paredes, DMD
• Cheleen Chaerin Park, PHARMD
• David Joon Park, MD
• Jason Park, OTR/L
• Jin Hyun Park
• Mie Hea Park
• Sae Yeon Park, APN
• Selin Park, FNP

• Family Nurse Practitioner in Englewood, NJ
• Providers in Englewood, NJ by specialty
• Family Nurse Practitioner in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 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.