Individual provider Active NPI

Esther K Park, PHARMD

  • Pharmacist
  • Dyer, IN
National Provider Identifier
1710256979
Registry record updated Dec 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
26024226A Issued in IN
Practice address
2761 Wood Dr
Dyer, IN 46311-2143
Phone
(219) 776-9922
NPI assigned
Dec 17, 2011
Last updated
Dec 17, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 26024226A IN Primary

Addresses

Primary practice location

2761 Wood Dr
Dyer, IN 46311-2143

Mailing address

2761 Wood Dr
Dyer, IN 46311-2143
Phone (219) 776-9922

Other identifiers 1

IdentifierTypeStateIssuer
26024226AOtherINSTATE PHARMACY BOARD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
26024226AINMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1324080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1324080000000",
    "number": "1710256979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2761 WOOD DR",
            "city": "DYER",
            "state": "IN",
            "postal_code": "463112143",
            "telephone_number": "219-776-9922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2761 WOOD DR",
            "city": "DYER",
            "state": "IN",
            "postal_code": "463112143",
            "telephone_number": "219-776-9922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "ESTHER",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-12-17",
        "last_updated": "2011-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IN",
            "license": "26024226A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE PHARMACY BOARD",
            "identifier": "26024226A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dyer, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2011; 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.