Sang M Park, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

6093 Issued in OR

Practice address

16144 SE Happy Valley Town Center Dr Ste 214
Happy Valley, OR 97086-4257

Phone

(503) 658-7715

NPI assigned

Jun 19, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: sang.park.1@16834.direct.athenahealth.com

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

{
    "created_epoch": "1592524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597017600000",
    "number": "1851917439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15826 SE MISTY DR UNIT 307",
            "city": "HAPPY VALLEY",
            "state": "OR",
            "postal_code": "970864354",
            "telephone_number": "913-706-6032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16144 SE HAPPY VALLEY TOWN CENTER DR STE 214",
            "city": "HAPPY VALLEY",
            "state": "OR",
            "postal_code": "970864257",
            "telephone_number": "503-658-7715"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12900 Falmouth St",
            "address_purpose": "LOCATION",
            "city": "Leawood",
            "state": "KS",
            "postal_code": "662091770",
            "country_code": "US",
            "telephone_number": "913-706-6032",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PARK",
        "first_name": "SANG",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-06-19",
        "last_updated": "2020-08-10",
        "certification_date": "2020-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "OR",
            "license": "6093",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Happy Valley, OR
• Providers in Happy Valley, OR by specialty
• Chiropractor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2020; 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.