James T. Park, APRN,FNP-C,DC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

1111605 Issued in TX

Practice address

904 Lexington St
Fort Worth, TX 76102-3550

Phone

(817) 335-2666

Fax

(817) 335-2669

NPI assigned

Aug 8, 2006

Last updated

Aug 8, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Latch D, PLLC

  dba Park Place Health Solutions

  • Family Medicine Physician
  • Fort Worth, TX
  • NPI 1801443361

  Multi-Specialty

  Medicare reassignment NPD
• Dr. James T. Park

  • Chiropractor
  • Fort Worth, TX
  • NPI 1770849077
  Authorized official Same address or phone
• Irst Health

  • Family Medicine Physician
  • Irving, TX
  • NPI 1841586179
  NPD (past)

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723075200000",
    "number": "1881604395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "904 LEXINGTON ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761023550",
            "telephone_number": "817-335-2666",
            "fax_number": "817-335-2669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "904 LEXINGTON ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761023550",
            "telephone_number": "817-335-2666",
            "fax_number": "817-335-2669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "JAMES",
        "middle_name": "T.",
        "name_prefix": "Dr.",
        "credential": "APRN,FNP-C,DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-08",
        "last_updated": "2024-08-08",
        "certification_date": "2024-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1111605",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "6892",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chad C Park, DDS
• Charlie Joon Park, CRNA
• Clinton Sangkyu Park, M.D.
• Glynis Park, MS
• Griffin Davis Park, DMD
• Jericho Bryan Park, MD
• Michael Park, DDS
• Miran Park
• Namsoon Park, MS
• Youna Park

• Family Nurse Practitioner in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.