Frederic C Park III, MD

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

21342 Issued in KY

Practice address

70 Doctors Park
Cape Girardeau, MO 63703-4928

Phone

(573) 334-6071

Fax

(812) 471-6650

NPI assigned

Sep 27, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in KY, IL, MO3 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 3

Specialty

Diagnostic Radiology

Education

University of Louisville School of Medicine, 1977

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cape Radiology Group PCGroup PAC ID 9830093236, 54 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercy Health - Lourdes Hospital Hospital, Paducah, KY, CCN 180102
• Massac Memorial Hospital Hospital, Metropolis, IL, CCN 141323
• Deaconess Illinois Union County Hospital, Anna, IL, CCN 141342
• Herrin Hospital Hospital, Herrin, IL, CCN 140011
• Memorial Hospital of Carbondale Hospital, Carbondale, IL, CCN 140164

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Cape Radiology Group, P.C.

  • Diagnostic Radiology Physician
  • Cape Girardeau, MO
  • NPI 1477506392

  IL, KY

  Medicare reassignment Care Compare group NPD
• Mercy Hospital Perry

  • Critical Access Hospital
  • Perryville, MO
  • NPI 1063117158

  Diagnostic Radiology

  Medicare reassignment NPD
• Mercy Health Physicians Kentucky Specialty Care LLC

  • Surgery Physician
  • Paducah, KY
  • NPI 1700408093
  Medicare reassignment NPD
• X-Ray Associates

  • Diagnostic Radiology Physician
  • Hartford, KY
  • NPI 1043314693
  NPD (past) Authorized official
• Mercy Hospital Perry

  • Rural Health Clinic/Center
  • Perryville, MO
  • NPI 1215613880
  NPD
• Mercy Hospital Perry

  • Rural Health Clinic/Center
  • Perryville, MO
  • NPI 1639858855
  NPD
• Mercy Health Physicians Kentucky Specialty Care LLC

  • Durable Medical Equipment & Medical Supplies
  • Paducah, KY
  • NPI 1043088347
  NPD
• Baptist Healthcare System, Inc

  • General Acute Care Hospital
  • Paducah, KY
  • NPI 1730264128
  NPD (past)
• Mercy Health Physicians Kentucky LLC

  • Family Medicine Physician
  • Paducah, KY
  • NPI 1922243690
  NPD (past)
• Radiology PSC

  • Diagnostic Radiology Physician
  • Owensboro, KY
  • NPI 1700976743
  NPD (past)

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

• Deaconess Illinois Union County Hospital Inc

  • Critical Access Hospital
  • Anna, IL
  • NPI 1710604483
  Care Compare affiliation
• Massac Memorial Hospital

  • Critical Access Hospital
  • Metropolis, IL
  • NPI 1790788578
  Care Compare affiliation
• Mercy Health-Lourdes Hospital LLC

  • Clinical Medical Laboratory
  • Paducah, KY
  • NPI 1245620640

  Hospital

  Care Compare affiliation
• Mercy Health-Lourdes Hospital LLC

  • General Acute Care Hospital
  • Paducah, KY
  • NPI 1346244126
  Care Compare affiliation
• Southern Illinois Hospital Services

  • General Acute Care Hospital
  • Carbondale, IL
  • NPI 1093801797
  Care Compare affiliation
• Southern Illinois Hospital Services

  • General Acute Care Hospital
  • Herrin, IL
  • NPI 1528158573
  Care Compare affiliation

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659398400000",
    "number": "1821189002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70 DOCTORS PARK",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637034928",
            "telephone_number": "573-334-6071",
            "fax_number": "812-471-6650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 DOCTORS PARK",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637034928",
            "telephone_number": "573-334-6071",
            "fax_number": "812-471-6650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "FREDERIC",
        "middle_name": "C",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-27",
        "last_updated": "2022-08-02",
        "certification_date": "2022-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "KY",
            "license": "21342",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Allison Danielle Palmer, BCBA
• Bobbi J Palmer, FNP-C
• Lori Alyse Palmer, LBSW
• Charles H Pancoast, MD
• Park Pharmacy, LLC
• Kee Bum Park, MD
• Derrall Shawn Parker, M.D.
• Linda Parker
• Scott Andrew Parker, MS, ATC
• Sylvester Parker, DDS

• Diagnostic Radiology Physician in Cape Girardeau, MO
• Providers in Cape Girardeau, MO by specialty
• Diagnostic Radiology Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2022; 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.