Samue C. Park, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

MC05716 Issued in NJ

Practice address

810 Abbott Blvd Ste 304
Fort Lee, NJ 07024-4117

Phone

(201) 886-7080

Fax

(201) 886-8069

NPI assigned

Nov 6, 2006

Sex

Male

Sole proprietor

No

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)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• SM Chiropractic&Pain Clinic, P.C.

  • Chiropractor
  • Fort Lee, NJ
  • NPI 1518172360
  NPD (past) Authorized official
• Harlem Firstaid Medical PC

  • Internal Medicine Physician
  • Flushing, NY
  • NPI 1881903284
  NPD (past)
• Ray C Miranda MD PLLC

  • Internal Medicine Physician
  • Flushing, NY
  • NPI 1578891826
  NPD (past)

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

{
    "created_epoch": "1162771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1801965918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "810 ABBOTT BLVD STE 304",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070244117",
            "telephone_number": "201-886-7080",
            "fax_number": "201-886-8069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 ABBOTT BLVD STE 304",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070244117",
            "telephone_number": "201-886-7080",
            "fax_number": "201-886-8069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "SAMUE",
        "middle_name": "C.",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-06",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "MC05716",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X009870",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeong In Park, PHARMACIST
• Jihye Park, DDS
• Jonghee Park
• Jung Chul Park
• Margaret Chu Park, D.M.D.
• Sara Park
• Shul Hyung Park, R.PH
• Soui Park
• Sun H Park, DC
• Susanna Miran Park, L.AC.

• Chiropractor in Fort Lee, NJ
• Providers in Fort Lee, NJ by specialty
• Chiropractor in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.

Verify at the official NPI Registry.