Jodie Park, SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

020569 Issued in NY

Practice address

220 5TH Ave
Apt 3
Brooklyn, NY 11215-2048

Phone

(678) 612-6863

NPI assigned

Jul 16, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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": "1247702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480464000000",
    "number": "1720218357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 5TH AVE",
            "address_2": "APT 3",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112152048",
            "telephone_number": "678-612-6863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 5TH AVE",
            "address_2": "APT 3",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112152048",
            "telephone_number": "678-612-6863"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "JODIE",
        "credential": "SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-07-16",
        "last_updated": "2016-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "SLP 004997",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "020569",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hannah Katherine Park, M.D.
• Hyunbin Park, M.D
• Jenny Ye Eun Park, DPM
• Ji Hyun Park, MD
• Jinwoo Michael Park, D.D.S.
• Jung Uk Park
• Juseok Park
• Justin Changgyu Park
• Lala Park
• Laura Park, OTR/L

• Speech-Language Pathologist in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Speech-Language Pathologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2016; 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.