Active NPI
Michael K Park, MD
- Family Medicine Physician
- Evergreen, CO
National Provider Identifier
1942229505
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 39042
- Practice address
- 3445 Woody CRK
Evergreen, CO 80439-7996 - Phone
- (303) 999-7507
- NPI assigned
- Jul 18, 2006
- Last updated
- Dec 19, 2013
- 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 39042 | CO | Primary |
Addresses
Primary practice location
3445 Woody CRK
Evergreen, CO 80439-7996
Mailing address
3445 Woody CRK
Evergreen, CO 80439-7996
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 39042 | CO | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Peak Family Medicine PC | Past | Accepting new patients | |
| HCA-Healthone, LLC | Past | Accepting new patients | |
| Vail Clinic, Inc. | Past | Accepting new patients | |
| Inpatient Consultants of Colorado, PC | Family Medicine | Past | Accepting new patients |
| HCA-Healthone, LLC Dba Rose Family Medicine Center | Family Medicine | Past | Accepting new patients |
| Inpatient Consultants of Colorado PC | Family Medicine | Past | Accepting new patients |
| VVMC Diversified Services | Past | Accepting new patients |
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/FBFADA
Organizations & group practices 7
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.
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-
- Internal Medicine Physician
- Denver, CO
- NPI 1538461256
Family Medicine
-
- Primary Care Clinic/Center
- Denver, CO
- NPI 1326218553
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153180800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1387411200000",
"number": "1942229505",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3445 WOODY CRK",
"city": "EVERGREEN",
"state": "CO",
"postal_code": "804397996"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3445 WOODY CRK",
"city": "EVERGREEN",
"state": "CO",
"postal_code": "804397996",
"telephone_number": "303-999-7507"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PARK",
"first_name": "MICHAEL",
"middle_name": "K",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-18",
"last_updated": "2013-12-19",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "CO",
"license": "39042",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Evergreen, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.