Ryan Park, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

APRN11030031 Issued in FL

Practice address

559 W Twincourt TRL Ste 607-608
Saint Augustine, FL 32095-8805

Phone

(904) 230-3006

Fax

(877) 638-8891

NPI assigned

Jul 27, 2012

Last updated

Mar 6, 2024By the provider in NPPES

Sex

Male

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

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Solantic of Jacksonville LLCGroup PAC ID 1052409307, 56 clinicians

Estate Ventures LLCGroup PAC ID 6103132352, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/DCDDAD/Endpoint/DCDDAD

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.

• Estate Ventures, LLC

  dba McGreevy Neurohealth

  • Pain Medicine Physician
  • St Augustine, FL
  • NPI 1033505706

  Multi-Specialty

  Medicare reassignment Care Compare group NPD
• Solantic of Jacksonville, LLC

  dba CareSpot Express Healthcare

  • Urgent Care Clinic/Center
  • Ponte Vedra, FL
  • NPI 1407893100

  Multi-Specialty

  Medicare reassignment Care Compare group NPD
• Carespot of Orlando Hsi Urgent Care LLC

  dba CareSpot Urgent Care / CareSpot - Clermont

  • Urgent Care Clinic/Center
  • Orlando, FL
  • NPI 1306367503

  Multi-Specialty

  Medicare reassignment NPD
• Hma/Solantic Joint Venture, LLC

  • Urgent Care Clinic/Center
  • Vero Beach, FL
  • NPI 1689812109

  Multi-Specialty

  Medicare reassignment NPD
• Solantic/South Florida, LLC

  dba CareSpot Express Healthcare

  • Urgent Care Clinic/Center
  • Coral Springs, FL
  • NPI 1851344378

  Multi-Specialty

  Medicare reassignment NPD
• West Boynton Urgent Care, LLC

  • Urgent Care Clinic/Center
  • Boynton Beach, FL
  • NPI 1003172628

  Multi-Specialty

  Medicare reassignment NPD
• BMH, Inc.

  dba Bingham Memorial Physicians & Surgeons Center

  • Surgery Physician
  • Blackfoot, ID
  • NPI 1255539193

  Multi-Specialty

  NPD
• McGreevy Neurohealth Palm Coast

  • Neurology Physician
  • Palm Coast, FL
  • NPI 1043670532

  Multi-Specialty

  NPD (past)
• Solantic of Jacksonville, LLC

  dba CareSpot-Yulee

  • Urgent Care Clinic/Center
  • Yulee, FL
  • NPI 1902574635
  NPD (past)

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

{
    "created_epoch": "1343347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709683200000",
    "number": "1760738728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "559 W TWINCOURT TRL STE 607-608",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320958805",
            "telephone_number": "904-230-3006",
            "fax_number": "877-638-8891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "559 W TWINCOURT TRL STE 607-608",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320958805",
            "telephone_number": "904-230-3006",
            "fax_number": "877-638-8891"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "360 E Montvue Dr. Ste 100",
            "address_purpose": "LOCATION",
            "city": "Meridian",
            "state": "ID",
            "postal_code": "83642",
            "country_code": "US",
            "telephone_number": "208-855-2900",
            "fax_number": "208-898-9877",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1021 Cesery Blvd",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322115609",
            "country_code": "US",
            "telephone_number": "904-743-2466",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "57 Town Ct Ste 123",
            "address_purpose": "LOCATION",
            "city": "Palm Coast",
            "state": "FL",
            "postal_code": "321642425",
            "country_code": "US",
            "telephone_number": "904-230-3006",
            "fax_number": "877-638-8891",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PARK",
        "first_name": "RYAN",
        "name_prefix": "Mr.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-07-27",
        "last_updated": "2024-03-06",
        "certification_date": "2024-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN11030031",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ID",
            "license": "NP-1200A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paper Crane Wellness Services LLC
• Monica Parco, MSN, FNP-C
• Daniel Paredes, DPT
• Parent Psych LLC
• Tina Parikh, DPT
• Kendall Parker
• Vicki Lynn Parks, DNP, ARNP-BC
• Heinrich Uwe Parl, M.D.
• Alison Lynn Parsons, PT, DPT
• Janet Marie Partyka, PT

• Nurse Practitioner in St Augustine, FL
• Providers in St Augustine, FL by specialty
• Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2024; 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.