Park Medical, LLC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

25559 Issued in SC

Legal business name

PARK MEDICAL, LLC

Practice address

8 Cedar Glenn Way
Simpsonville, SC 29681-6396

Phone

(864) 640-0395

NPI assigned

Sep 27, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Sonny Y Park, MD

Title

Owner

Phone

(864) 640-0395

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1285545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1299715200000",
    "number": "1831408764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 CEDAR GLENN WAY",
            "city": "SIMPSONVILLE",
            "state": "SC",
            "postal_code": "296816396",
            "telephone_number": "864-640-0395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 CEDAR GLENN WAY",
            "city": "SIMPSONVILLE",
            "state": "SC",
            "postal_code": "296816396",
            "telephone_number": "864-640-0395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARK MEDICAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-27",
        "last_updated": "2011-03-10",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "SONNY",
        "authorized_official_middle_name": "Y",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "864-640-0395",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "SC",
            "license": "25559",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Palmetto Prosthodontics, LLC
• Bobby Papariella
• Julie U. Park, M.D.
• Jennie Ann Parker, PHARMD
• Kenneth Parker
• Stephen E Parks, MD
• Erin Elizabeth Parmelee, PT, DPT

• General Practice Physician in Simpsonville, SC
• Providers in Simpsonville, SC by specialty
• General Practice Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2011; 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.