Active NPI
Adrienne D Parks, PAC
- Physician Assistant
- Scottsburg, IN
National Provider Identifier
1518214865
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 10001411A
- Practice address
- 1441 N Gardner St
Scottsburg, IN 47170-7751 - Phone
- (812) 752-4055
- Fax
- (812) 752-4188
- NPI assigned
- Aug 6, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 10001411A | IN | Primary |
Addresses
Primary practice location
1441 N Gardner St
Scottsburg, IN 47170-7751
Mailing address
1441 N Gardner St
Scottsburg, IN 47170-7751
Phone (812) 752-4055
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20121126000026 | IN | Practitioner - Physician Assistant | 7113178187 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- University of Kentucky College of Medicine, 2011
- Medicare assignment
- May accept Medicare assignment
- Group practices
- St. Luke'S Medical Ministry
Practice addresses (Care Compare)
1441 N Gardner St
Scottsburg, IN 47170-7751
Phone (812) 752-4055
Hospital & facility affiliations
- Caretenders
- Norton Scott Hospital
- Norton Clark Hospital
- Schneck Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10001411A | IN | MD | Physician Assistant |
Interoperability endpoints
- adrienne.parks.p1@direct.stlukesmedicalmin.nextgenshare.com
Organizations & group practices 1
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.
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Home Health Agency
- New Albany, IN
- NPI 1366549560
-
- General Acute Care Hospital
- Seymour, IN
- NPI 1699738088
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1344211200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1344211200000",
"number": "1518214865",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1441 N GARDNER ST",
"city": "SCOTTSBURG",
"state": "IN",
"postal_code": "471707751",
"telephone_number": "812-752-4055",
"fax_number": "812-752-4188"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1441 N GARDNER ST",
"city": "SCOTTSBURG",
"state": "IN",
"postal_code": "471707751",
"telephone_number": "812-752-4055",
"fax_number": "812-752-4188"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PARKS",
"first_name": "ADRIENNE",
"middle_name": "D",
"name_prefix": "Mrs.",
"credential": "PAC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-08-06",
"last_updated": "2012-08-06",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "IN",
"license": "10001411A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Scottsburg, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2012; 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.