Parks Dermatology Center LLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

PARKS DERMATOLOGY CENTER LLC

Practice address

400 Lakebridge Plaza Dr
Ormond Beach, FL 32174-5157

Phone

(386) 677-9044

Fax

(386) 677-3083

NPI assigned

Sep 15, 2005

Last updated

Apr 12, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Jeffrey Dean Parks, M.D.NPI 1336134360

Title

President

Phone

(386) 677-9044

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 25

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jeffrey Dean Parks, MD

  • Dermatology Physician
  • Ormond Beach, FL
  • NPI 1336134360
  Medicare reassignment Care Compare group NPD Authorized official
• Ida Jutting Bell, NP

  • Nurse Practitioner
  • Port Orange, FL
  • NPI 1710330733
  Medicare reassignment Care Compare group NPD
• Courtney Nicole Bernett, DO

  • Dermatology Physician
  • Ormond Beach, FL
  • NPI 1265887152
  Medicare reassignment Care Compare group NPD
• John Christopher Coppola, DO

  • Dermatology Physician
  • Ormond Beach, FL
  • NPI 1346462181
  Medicare reassignment Care Compare group NPD
• Michelle Whiddon Foley, D.O.

  • Dermatology Physician
  • Ormond Beach, FL
  • NPI 1730375700
  Medicare reassignment Care Compare group NPD
• Abigail Grace Galiardo, APRN

  • Family Nurse Practitioner
  • Maitland, FL
  • NPI 1770466385
  Medicare reassignment Care Compare group NPD
• Karthik Krishnamurthy, D.O.

  • MOHS-Micrographic Surgery Physician
  • Palm Coast, FL
  • NPI 1770726291

  Dermatology

  Medicare reassignment Care Compare group NPD
• Julianne Mitchell, APRN

  • Nurse Practitioner
  • Ormond Beach, FL
  • NPI 1417775206
  Medicare reassignment Care Compare group NPD
• Noah Harrison Prince, M.D.

  • Plastic Surgery Physician
  • Gainesville, FL
  • NPI 1750721585

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Simona Sokolska

  • Physician Assistant
  • Palm Coast, FL
  • NPI 1871387266
  Medicare reassignment Care Compare group NPD
• Savannah Crist Munier

  • Physician Assistant
  • Palm Coast, FL
  • NPI 1073260196
  Medicare reassignment Care Compare group
• Olivia Marie Crocker

  • Physician Assistant
  • New Smyrna Beach, FL
  • NPI 1740987668
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1126742400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1491955200000",
    "number": "1629063680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 LAKEBRIDGE PLAZA DR",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321745157",
            "telephone_number": "386-677-9044",
            "fax_number": "386-677-3083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 LAKEBRIDGE PLAZA DR",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321745157",
            "telephone_number": "386-677-9044",
            "fax_number": "386-677-3083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARKS DERMATOLOGY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-15",
        "last_updated": "2017-04-12",
        "status": "A",
        "authorized_official_last_name": "PARKS",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "DEAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "386-677-9044",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jawed Panja
• Ankit Shrikant Parikh, DMD
• Hansa M Parikh, M.D.
• Parker Bowen DC LLC
• Stephanie Parker, DC
• Jeffrey Dean Parks, MD
• Karyn Russell Parks, OTR
• Cindy Parr
• Gregory Alan Parr, M.D.
• Partnering for Community Care (Empower Health)

• Dermatology Physician in Ormond Beach, FL
• Providers in Ormond Beach, FL by specialty
• Dermatology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.