Individual provider Active NPI

John Park

  • Certified Registered Nurse Anesthetist
  • Mobile, AL
National Provider Identifier
1831769538
Registry record updated May 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
143421 Issued in AL
Practice address
2451 University Hospital Dr
Mobile, AL 36617-2300
Phone
(509) 339-4348
NPI assigned
Jun 26, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 143421 AL Primary

Addresses

Primary practice location

2451 University Hospital Dr
Mobile, AL 36617-2300

Mailing address

151 Du Rhu Dr Apt 2407
Mobile, AL 36608-1274
Phone (509) 339-4348

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL, ID2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230606000766 AL Practitioner - Certified Registered Nurse Anesthetist (Crna) 8921465048 Reassigns benefits to 1 organization
I20250928000076 ID Practitioner - Certified Registered Nurse Anesthetist (Crna) 8921465048 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Alphonsus Professional Medical Services LLCGroup PAC ID 7214849751, 124 clinicians
USA Health Anesthesia Billing Services LLCGroup PAC ID 1153659123, 160 clinicians

Practice addresses (Care Compare)

1055 N Curtis Rd
Boise, ID 83706-1309
Phone (208) 367-2152

1700 Ctr St
Mobile, AL 36604-3301
Phone (251) 471-1000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
143421ALMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
St Alphonsus Professional Medical Services LLC CurrentSince Oct 6, 2025 Accepting new patients
USA Health Anesthesia Billing Services, LLC Nurse Anesthetist, Certified Registered CurrentSince Jun 1, 2023 Accepting new patients
St Alphonsus Professional Medical Services LLC CurrentSince Oct 6, 2025 Accepting new patients

Locations

2451 University Hospital Dr
Mobile, AL 36617
Phone (251) 471-7000

2451 Fillingim St
Mobile, AL 36617
Phone (251) 434-3711

1700 Center St
Mobile, AL 36604
Phone (251) 415-1000

1055 N Curtis Rd
Boise, ID 83706
Phone (208) 367-2152

Organizations & group practices 3

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 5

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": "1624665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683244800000",
    "number": "1831769538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "151 DU RHU DR APT 2407",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366081274",
            "telephone_number": "509-339-4348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2451 UNIVERSITY HOSPITAL DR",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366172300",
            "telephone_number": "509-339-4348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "JOHN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-26",
        "last_updated": "2023-05-05",
        "certification_date": "2023-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AL",
            "license": "143421",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mobile, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.