Susan Young Park, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP136484 Issued in TX

Practice address

2242 Repsdorph Rd
Seabrook, TX 77586-1566

Phone

(866) 389-2727

Fax

(401) 216-3854

NPI assigned

Feb 15, 2018

Last updated

Mar 13, 2020By the provider in NPPES

Sex

Female

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

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Minuteclinic Diagnostic of Texas PLLC

  • Family Nurse Practitioner
  • Round Rock, TX
  • NPI 1609076330
  Medicare reassignment NPD
• Minuteclinic Telehealth Services of Texas Association

  • Family Nurse Practitioner
  • Round Rock, TX
  • NPI 1922564301
  Medicare reassignment NPD
• Minuteclinic Diagnostic of Texas PLLC

  • Clinical Social Worker
  • Katy, TX
  • NPI 1740898188
  NPD
• Primary Care PLLC

  • Family Nurse Practitioner
  • Spring, TX
  • NPI 1770354763
  NPD

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

{
    "created_epoch": "1518652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584057600000",
    "number": "1609376797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2242 REPSDORPH RD",
            "city": "SEABROOK",
            "state": "TX",
            "postal_code": "77586",
            "telephone_number": "866-389-2727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2242 REPSDORPH RD",
            "city": "SEABROOK",
            "state": "TX",
            "postal_code": "775861566",
            "telephone_number": "866-389-2727",
            "fax_number": "401-216-3854"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "SUSAN",
        "middle_name": "YOUNG",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-02-15",
        "last_updated": "2020-03-13",
        "certification_date": "2020-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP136484",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Blanca Diez Nahmias, M.D.
• William Eugene Nelson, CSFA
• Theresa Nguyen, PHARMD
• Orthopaedic Movement Specialists of America PLLC
• Vanessa Lynn Paelicke, L.C.S.W.
• Virendra Jashbhai Patel, RPH
• Bernard Michael Patten, M.D.
• Paul's Farm Inc. (A&G Personal Provider Services)
• Emily Paultz
• Pawsitive Connections Counseling Center

• Family Nurse Practitioner in Seabrook, TX
• Providers in Seabrook, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.