Barbara Park, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

02329 Issued in IA

Practice address

3425 E Locust St Ste 101
Davenport, IA 52803-3573

Phone

(563) 332-6596

Fax

(563) 888-1626

NPI assigned

Sep 28, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: abc.barbarapark@152811.advancedmd-direct.com

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.

• Back 2 Action Physical Therapy LLC

  • Physical Therapist
  • Davenport, IA
  • NPI 1427509090
  NPD Authorized official

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

{
    "created_epoch": "1475020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697587200000",
    "number": "1831648153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3425 E LOCUST ST STE 101",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528033573",
            "telephone_number": "563-332-6596",
            "fax_number": "563-888-1626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3425 E LOCUST ST STE 101",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528033573",
            "telephone_number": "563-332-6596",
            "fax_number": "563-888-1626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "BARBARA",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-09-28",
        "last_updated": "2023-10-18",
        "certification_date": "2023-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IA",
            "license": "02329",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRIVATE INSURANCE",
            "identifier": "81-3903851",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "81-3903851",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Judith Geralyn Pancratz, LISW
• Amy Cora Panich, M.S., CCC-SLP
• Jessica Pape, LMHC
• Polly Jo Papesh, PHARMD
• James C. Parcel, LMHC
• James Vance Park, MD
• So Eun Park, DDS
• Parker Audiology, P.C.
• Molly Parker, AU.D., CCC-A
• Leann Parks, PHARMD

• Physical Therapist in Davenport, IA
• Providers in Davenport, IA by specialty
• Physical Therapist in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2023; 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.