Tennessee Park, MD

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

1215 Lee St
Mail Stop 800699
Charlottesville, VA 22908-0816

Phone

(434) 924-8485

Fax

(434) 982-4118

NPI assigned

Mar 24, 2020

Sex

Male

Sole proprietor

No

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 VA

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

Emergency Medicine

Education

University of South Florida College of Medicine, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Fredericksburg Emergency Medical Alliance, Inc.Group PAC ID 2163412636, 47 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mary Washington Hospital Hospital, Fredericksburg, VA, CCN 490022
• Stafford Hospital, LLC Hospital, Stafford, VA, CCN 490140

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Fredericksburg Emergency Medical Alliance, Inc.

  • Emergency Medicine Physician
  • Fredericksburg, VA
  • NPI 1396779153
  Medicare reassignment Care Compare group NPD

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

• Mary Washington Hospital Inc.

  • General Acute Care Hospital
  • Fredericksburg, VA
  • NPI 1942288527
  Care Compare affiliation
• Mary Washington Hospital, Inc.

  • Cardiovascular Disease Physician
  • Fredericksburg, VA
  • NPI 1013089879

  Hospital

  Care Compare affiliation
• Mary Washington Hospital, Inc.

  • Home Health Agency
  • Fredericksburg, VA
  • NPI 1407814163

  Hospital

  Care Compare affiliation
• Stafford Hospital, LLC

  • General Acute Care Hospital
  • Stafford, VA
  • NPI 1043343304
  Care Compare affiliation

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

{
    "created_epoch": "1585008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585008000000",
    "number": "1619504388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1215 LEE ST",
            "address_2": "MAIL STOP 800699",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229080816",
            "telephone_number": "434-924-8485",
            "fax_number": "434-982-4118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 LEE ST",
            "address_2": "MAIL STOP 800699",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229080816",
            "telephone_number": "434-924-8485",
            "fax_number": "434-982-4118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "TENNESSEE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-24",
        "last_updated": "2020-03-24",
        "certification_date": "2020-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joseph S. Park, MD
• Sa Ra Park
• Stacy Cain Park, MD
• Stephen S. Park
• Sungho Christian Park, PHARMD
• John David Parker, PHARMD
• Lindsey Ann Parker, CPNP
• Richard Anthony Parker, D.D.S.
• William D. Parker
• Jill Podelco Parks, RPH

• Student in an Organized Health Care Education/Training Program in Charlottesville, VA
• Providers in Charlottesville, VA by specialty
• Student in an Organized Health Care Education/Training Program in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 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.
• 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.