Chan Kyu Park, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CHIR009022 Issued in GA

Practice address

6630 McGinnis Ferry Rd
Suite B
Johns Creek, GA 30097-2164

Phone

(678) 473-0552

Fax

(678) 473-0656

NPI assigned

Oct 20, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Specialty

Chiropractic

Education

Life Chiropractic College, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Better Spine Better Health, LLC

  • Rehabilitation Chiropractor
  • Johns Creek, GA
  • NPI 1588908685
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1445299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642118400000",
    "number": "1639541485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6630 MCGINNIS FERRY RD STE B",
            "city": "JOHNS CREEK",
            "state": "GA",
            "postal_code": "300971563",
            "telephone_number": "678-473-0552",
            "fax_number": "678-473-0656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6630 MCGINNIS FERRY RD",
            "address_2": "SUITE B",
            "city": "JOHNS CREEK",
            "state": "GA",
            "postal_code": "300972164",
            "telephone_number": "678-473-0552",
            "fax_number": "678-473-0656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "CHAN KYU",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-10-20",
        "last_updated": "2022-01-14",
        "certification_date": "2022-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Rehabilitation",
            "state": "GA",
            "license": "CHIR009022",
            "primary": false
        },
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "GA",
            "license": "CHIR009022",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIR009022",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1588908685",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pandya Medical Center, Inc
• Tanya Oberoi Pandya, D.O., M.B.A.
• Parallel Play, Inc (Parallel Play)
• Nirdesh Parikh, DMD
• Nitin J Parikh, MD
• Hanna Lee Park, FNP-C
• Minhee Park
• Rebekah Hee Jin Park
• Aleisha Parker
• Marcie D Parker

• Chiropractor in Johns Creek, GA
• Providers in Johns Creek, GA by specialty
• Chiropractor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2022; 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.