Ben H Park, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

01027843 Issued in IN

Practice address

1310 S Lebanon St
Lebanon, IN 46052-2792

Phone

(765) 482-7005

NPI assigned

Oct 31, 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

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Indiana Care Organization, LLC

  • Clinic/Center
  • Indianapolis, IN
  • NPI 1619458940
  NPD Authorized official
• American Health Network of Kentucky, LLC

  • Internal Medicine Physician
  • Louisville, KY
  • NPI 1225643992

  Family Medicine

  NPD
• American Health Network of Ohio, LLC

  • Radiology Clinic/Center
  • Columbus, OH
  • NPI 1548142987
  NPD (past)

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

{
    "created_epoch": "1162252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616976000000",
    "number": "1841377702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1310 S LEBANON ST",
            "city": "LEBANON",
            "state": "IN",
            "postal_code": "460522792",
            "telephone_number": "765-482-7005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1310 S LEBANON ST",
            "city": "LEBANON",
            "state": "IN",
            "postal_code": "460522792",
            "telephone_number": "765-482-7005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "BEN",
        "middle_name": "H",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-31",
        "last_updated": "2021-03-29",
        "certification_date": "2021-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01027843",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100063190",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ben.parkmd.p9@direct.ahni.nextgenshare.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "1310 S Lebanon St",
            "city": "Lebanon",
            "state": "IN",
            "country_code": "US",
            "postal_code": "460522792",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Ossip Optometry, P.C.
• Alice Camille Otto, NP
• Autumn Overbay, LCSW
• Marissa Overbey, RBT
• Nicole Marie Owens
• Annabel G Parks, DT
• Melanthi Parpas
• Jenish Manubhai Patel
• Mehul M Patel, MD
• Mita Patel, M.D.

• Family Medicine Physician in Lebanon, IN
• Providers in Lebanon, IN by specialty
• Family Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2021; 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.