Chris C Park, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

D56316 Issued in MD

Practice address

655 Watkins Mill Rd
Gaithersburg, MD 20879-3301

Phone

(240) 632-4000

NPI assigned

Dec 2, 2006

Last updated

Jun 30, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Chung H Park Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MD, DC2 enrollments

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 2

Specialty

Internal Medicine

Education

Medical University of South Carolina College of Medicine, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kaiser Foundation Health Plan of the Mid Atlantic States, IncGroup PAC ID 3779495858, 1,921 clinicians

Practice addresses (Care Compare)

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

• Kaiser Foundation Health Plan of the Mid Atlantic States, Inc

  • Health Maintenance Organization
  • Halethorpe, MD
  • NPI 1043378656
  Medicare reassignment Care Compare group NPD
• Kaiser Foundation Health Plan of the Mid Atlantic States, Inc

  dba Kaiser Permanente Annapolis Medical Center

  • Health Maintenance Organization
  • Annapolis, MD
  • NPI 1952461816

  DC, Internal Medicine

  Medicare reassignment NPD
• Kaiser Foundation Health Plan of the Mid Atlantic States, Inc

  dba North Arundel Medical Center

  • Health Maintenance Organization
  • Glen Burnie, MD
  • NPI 1285752121
  NPD
• Kaiser Foundation Health Plan of the Mid Atlantic States, Inc

  dba Kaiser Permanente Shady Grove Peritoneal Dialysis Facility

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Rockville, MD
  • NPI 1962108753
  NPD
• Kaiser Foundation Health Plan of the Mid Atlantic States, Inc

  dba Kaiser Permanente Capitol Hill Medical Center

  • Health Maintenance Organization
  • Washington, DC
  • NPI 1093016933
  NPD
• Frederick Health Hospital Inc

  dba Frederick Health Hospital

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)
• Lima Memorial Joint Operating Company

  dba Lima Memorial Health System

  • General Acute Care Hospital
  • Lima, OH
  • NPI 1336144732
  NPD (past)

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

{
    "created_epoch": "1165017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625011200000",
    "number": "1649348087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "655 WATKINS MILL RD",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208793301",
            "telephone_number": "240-632-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 WATKINS MILL RD",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208793301",
            "telephone_number": "240-632-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "CHRIS",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-02",
        "last_updated": "2021-06-30",
        "certification_date": "2021-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35.094595",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D56316",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3004528",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggat",
            "affiliation": "N",
            "endpointDescription": "carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "655 Watkins Mill Rd",
            "city": "Gaithersburg",
            "state": "MD",
            "country_code": "US",
            "postal_code": "208793301",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "CHUNG",
            "last_name": "PARK",
            "middle_name": "H",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Heidi Panther
• Hector Jorge Parada, MD
• Sneha Parangot, BCBA
• Parents Choice Pediatric and Occupational Therapy Cener
• Park Pediatrics
• Parker Medical Supplies,LLC
• Brittney Parker
• Rogenia Parker, LCSW
• Symone Sanora Parker
• Laura Kristen Parkins, AGPCNP

• Internal Medicine Physician in Gaithersburg, MD
• Providers in Gaithersburg, MD by specialty
• Internal Medicine Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2021; 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.