Individual provider Active NPI

Paul Park, MD

  • Neurological Surgery Physician
  • Memphis, TN
National Provider Identifier
1801993167
Registry record updated Aug 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
39675 Issued in TN
Practice address
6325 Humphreys Blvd
Memphis, TN 38120-2300
Phone
(901) 522-7700
Fax
(901) 522-2600
NPI assigned
Sep 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X 32050 MS
Neurological Surgery Physician 207T00000X 4301071842 MI
Neurological Surgery Physician 207T00000X 39675 TN Primary

Addresses

Primary practice location

6325 Humphreys Blvd
Memphis, TN 38120-2300

Mailing address

6325 Humphreys Blvd
Memphis, TN 38120-2300
Phone (901) 522-7700

Other practice location 1

1500 East Medical Center Dr
2nd floor Taubman Ctr Recp G
Ann Arbor, MI 48109-5338
Phone (734) 936-7010

Other practice location 2

391 Southcrest Cir Ste 205
Southaven, MS 38671-6729
Phone (901) 522-7700

Other identifiers 3

IdentifierTypeStateIssuer
200001052MedicaidMS
4812077MedicaidMI
Q076139MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, MS2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20050523001140 TN Practitioner - Neurosurgery 5991747768 Reassigns benefits to 1 organization
I20230922000589 MS Practitioner - Neurosurgery 5991747768 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurosurgery
Education
University of Michigan Medical School, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Semmes-Murphey Clinic PCGroup PAC ID 1254235914, 66 clinicians

Practice addresses (Care Compare)

391 Southcrest Cir
Suite 205
Southaven, MS 38671-6729
Phone (901) 260-6100

6325 Humphreys Blvd
Memphis, TN 38120-2300
Phone (901) 522-7700

Hospital & facility affiliations

  • Baptist Memorial Hospital Hospital, Memphis, TN, CCN 440048
  • Methodist Hospitals of Memphis Hospital, Memphis, TN, CCN 440049
  • St Bernards Medical Center Hospital, Jonesboro, AR, CCN 040020
  • St Francis Hospital Hospital, Memphis, TN, CCN 440183
  • Baptist Memorial Hospital Booneville Hospital, Booneville, MS, CCN 250044

Merit-based Incentive Payment System (MIPS)

Final score
82.8 of 100Reported as group
Quality
67.04
Promoting interoperability
100
Improvement activities
40
Cost
75.62

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion462
Laminectomy or laminotomy (partial removal of spine bones)101

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
32050MSMDNeurological Surgery Physician
39675TNMDNeurological Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Semmes-Murphey Clinic PC Current Accepting new patients
Semmes-Murphey Clinic PC Neurological Surgery CurrentSince Jul 25, 2022 Accepting new patients

Locations

391 Southcrest Cir
Ste 205
Southaven, MS 38671
Phone (662) 536-0900

6011 Airline Rd
Ste 102
Arlington, TN 38002
Phone (901) 557-7077

2996 Kate Bond Rd
Ste 211
Bartlett, TN 38133
Phone (731) 307-8888

9950 Crooked Creek Rd
Collierville, TN 38017
Phone (662) 822-3298

6325 Humphreys Blvd
Memphis, TN 38120
Phone (901) 522-7739

Interoperability endpoints

  • Direct secure messaging: paul.park.1@28653.direct.athenahealth.com
  • Direct secure messaging: ppark27605@direct.med.umich.edu
  • Direct secure messaging: ppark31803@mlh.direct-ci.com

Organizations & group practices 2

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691366400000",
    "number": "1801993167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6325 HUMPHREYS BLVD",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381202300",
            "telephone_number": "901-522-7700",
            "fax_number": "901-522-2600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6325 HUMPHREYS BLVD",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381202300",
            "telephone_number": "901-522-7700",
            "fax_number": "901-522-2600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1500 East Medical Center Dr",
            "address_2": "2nd floor Taubman Ctr Recp G",
            "address_purpose": "LOCATION",
            "city": "Ann Arbor",
            "state": "MI",
            "postal_code": "481095338",
            "country_code": "US",
            "telephone_number": "734-936-7010",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "391 Southcrest Cir Ste 205",
            "address_purpose": "LOCATION",
            "city": "Southaven",
            "state": "MS",
            "postal_code": "386716729",
            "country_code": "US",
            "telephone_number": "901-522-7700",
            "fax_number": "901-522-2600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PARK",
        "first_name": "PAUL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2023-08-07",
        "certification_date": "2023-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "MS",
            "license": "32050",
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "MI",
            "license": "4301071842",
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "TN",
            "license": "39675",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200001052",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4812077",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q076139",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.