Christopher A Park, M.D.

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

2007-00401 Issued in NC

Practice address

3700 Dauphin St Ste a
Mobile, AL 36608-1725

Phone

(251) 340-6600

Fax

(251) 479-7164

NPI assigned

Mar 7, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 7

Addresses

Other identifiers 10

Medicare fee-for-service enrollment

Enrolled in AL

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

Plastic and Reconstructive Surgery

Education

University of Alabama School of Medicine, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The Park Clinic for Cosmetic and Reconstructive Surgery, P.C.Group PAC ID 2466513064, 4 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Springhill Medical Center Hospital, Mobile, AL, CCN 010144

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• The Park Clinic for Cosmetic and Reconstructive Surgery, P.C.

  • Medical Specialty Clinic/Center
  • Mobile, AL
  • NPI 1821246869
  Medicare reassignment Care Compare group NPD Authorized official

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Springhill Hospitals, Inc

  • General Acute Care Hospital
  • Mobile, AL
  • NPI 1003814971
  Care Compare affiliation

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678838400000",
    "number": "1497885339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3700 DAUPHIN ST STE A",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366081725",
            "telephone_number": "251-340-6600",
            "fax_number": "251-479-7164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 DAUPHIN ST STE A",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366081725",
            "telephone_number": "251-340-6600",
            "fax_number": "251-479-7164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "CHRISTOPHER",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-07",
        "last_updated": "2023-03-15",
        "certification_date": "2023-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0105X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgery of the Hand",
            "state": "NC",
            "license": "2007-00401",
            "primary": false
        },
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "NC",
            "license": "2007-00401",
            "primary": false
        },
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "VA",
            "license": "0101241162",
            "primary": false
        },
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "VA",
            "license": "0101241162",
            "primary": false
        },
        {
            "code": "2082S0099X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery, Plastic Surgery Within the Head and Neck",
            "state": "NC",
            "license": "2007-00401",
            "primary": false
        },
        {
            "code": "2082S0099X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery, Plastic Surgery Within the Head and Neck",
            "state": "VA",
            "license": "0101241162",
            "primary": false
        },
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "NC",
            "license": "2007-00401",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810009016",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PTAN",
            "identifier": "510I240012",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST",
            "identifier": "202030",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "146F9",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PARTNERS",
            "identifier": "810641",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "9897073",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "510I240012",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "51595045",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5906699",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q0040L",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Paradise Residential LLC
• Christine Paragone, PA
• Madison Claire Parfait
• Kevin James Parham
• Susan Paris, OT
• Elizabeth Arnold Park, MD
• John Park
• Scott Arthur Park, P.T.
• Parker Adult Foster Home, Inc.
• Beverly Jane Parker, CRNP

• Plastic Surgery Physician in Mobile, AL
• Providers in Mobile, AL by specialty
• Plastic Surgery Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2023; 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.