Dedan Parks

Primary specialty

Home Health Registered NurseTaxonomy code 163WH0200X

License

03120085466 Issued in DC

Practice address

59 Forrester St SW Apt B
Washington, DC 20032-2120

Phone

(202) 718-9553

NPI assigned

Aug 6, 2019

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

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1565049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565049600000",
    "number": "1629623723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "59 FORRESTER ST SW APT B",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200322120",
            "telephone_number": "202-718-9553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "59 FORRESTER ST SW APT B",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200322120",
            "telephone_number": "202-718-9553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARKS",
        "first_name": "DEDAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-08-06",
        "last_updated": "2019-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "DC",
            "license": "03120085466",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "90874372",
            "state": "DC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "N/A",
            "affiliation": "N",
            "address_1": "59 Forrester St SW Apt B",
            "city": "Washington",
            "state": "DC",
            "country_code": "US",
            "postal_code": "200322120",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Xavier Ronald Parker Sr., MSW
• Parkhurst Associates MHS, Inc.
• John C Parkhurst, PH.D.
• Courtney Catherine Ruth Parkin, ACCNS, ACNP
• Glenn Walser Parkinson, MSW, MA
• Ebony Parks
• Erickaa Parks
• Ieasha Parks
• James Henry Parks IV, LICSW, MSW
• John Tice Parks, MD

• Home Health Registered Nurse in Washington, DC
• Providers in Washington, DC by specialty
• Home Health Registered Nurse in District of Columbia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.