Active NPI
Amber Kay Park
- Pediatric Occupational Therapist
- Phoenix, AZ
National Provider Identifier
1750468559
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Occupational Therapist
- License
- 3754
- Practice address
- 10251 N 35TH Ave
Phoenix, AZ 85051-1305 - Phone
- (602) 995-7366
- NPI assigned
- Nov 1, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Occupational Therapist | 225XP0200X | 3754 | AZ | Primary |
Addresses
Primary practice location
10251 N 35TH Ave
Phoenix, AZ 85051-1305
Mailing address
14237 W Wethersfield Rd
Surprise, AZ 85379-5541
Phone (509) 998-9930
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 214426 | Other | CERTIFICATION |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3754 | AZ | MD | Critical Care Medicine (Internal Medicine) Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162339200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1750468559",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14237 W WETHERSFIELD RD",
"city": "SURPRISE",
"state": "AZ",
"postal_code": "853795541",
"telephone_number": "509-998-9930"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10251 N 35TH AVE",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850511305",
"telephone_number": "602-995-7366"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PARK",
"first_name": "AMBER",
"middle_name": "KAY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-01",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225XP0200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Pediatrics",
"state": "AZ",
"license": "3754",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CERTIFICATION",
"identifier": "214426",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.