Active NPI
Carolyn Marie Park
- Registered Dietitian
- Ashville, OH
National Provider Identifier
1861291122
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- LD5046
- Practice address
- 5438 State Route 752
Ashville, OH 43103-9464 - Phone
- (740) 412-4383
- NPI assigned
- Mar 10, 2025
- Last updated
- Mar 10, 2025
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | LD5046 | OH | Primary |
Addresses
Primary practice location
5438 State Route 752
Ashville, OH 43103-9464
Mailing address
5438 State Route 752
Ashville, OH 43103-9464
Phone (740) 412-4383
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LD5046 | OH | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Marjorie Nolan Cohn LLC | Dietitian, Registered | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1741564800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1741564800000",
"number": "1861291122",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5438 STATE ROUTE 752",
"city": "ASHVILLE",
"state": "OH",
"postal_code": "431039464",
"telephone_number": "740-412-4383"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5438 STATE ROUTE 752",
"city": "ASHVILLE",
"state": "OH",
"postal_code": "431039464",
"telephone_number": "740-412-4383"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PARK",
"first_name": "CAROLYN",
"middle_name": "MARIE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-03-10",
"last_updated": "2025-03-10",
"certification_date": "2025-03-10",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "OH",
"license": "LD5046",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ashville, OH
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- Julia Diane Nace
- Natural Medicine,LLC (Ashville Chiropractic and Wellness Center)
- Amy Lelia Noltemeyer
- David Mathew Noltemeyer
- Pickaway Health Services
- Hunter Pietrzycki
- Cami Lynette Prater-Norpoth, LPCC., M.ED.
- Melissa Kay Puckett, RN
- Ram Transportation LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.