Active NPI
John Park
- Certified Registered Nurse Anesthetist
- Mobile, AL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 143421
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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, ID
Enrollment records 2
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
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
| License | State | Type | Specialty |
|---|---|---|---|
| 143421 | AL | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St Alphonsus Professional Medical Services LLC | Current | Accepting new patients | |
| USA Health Anesthesia Billing Services, LLC | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
| St Alphonsus Professional Medical Services LLC | Current | 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.
-
- Anesthesiology Physician
- Mobile, AL
- NPI 1629635818
Nurse Anesthetist, Certified Registered
-
dba SAMG Anesthesia
- Anesthesiology Physician
- Boise, ID
- NPI 1386677524
-
dba St Alphonsus Trauma Physician Services
- Trauma Surgery Physician
- Boise, ID
- NPI 1336166883
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Saint Alphonsus RMC TVL
- General Acute Care Hospital
- Boise, ID
- NPI 1184155426
-
dba St Alphonsus Rehabilitation Services
- General Acute Care Hospital
- Boise, ID
- NPI 1457414948
-
- Psychiatric Hospital Unit
- Boise, ID
- NPI 1770687857
-
- Family Medicine Physician
- Caldwell, ID
- NPI 1861676298
Hospital
-
- General Acute Care Hospital
- Boise, ID
- NPI 1992736649
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.