Kerri S. Parks, M. D., a Professional Medical Corporation

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

KERRI S. PARKS, M. D., A PROFESSIONAL MEDICAL CORPORATION

Practice address

1808 Verdugo Blvd
#208
Glendale, CA 91208-1477

Phone

(818) 952-5322

Fax

(818) 952-7993

NPI assigned

Dec 7, 2007

Last updated

Aug 6, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Kerri Shane Parks, M.D.NPI 1104893775

Title

President/ M.D.

Phone

(818) 952-5322

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kerri Shane Parks, M.D.

  • Specialist
  • Glendale, CA
  • NPI 1104893775
  Authorized official Same address or phone

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

{
    "created_epoch": "1196985600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1249516800000",
    "number": "1942483375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1808 VERDUGO BLVD",
            "address_2": "#208",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912081477",
            "telephone_number": "818-952-5322",
            "fax_number": "818-952-7993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1808 VERDUGO BLVD",
            "address_2": "#208",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912081477",
            "telephone_number": "818-952-5322",
            "fax_number": "818-952-7993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KERRI S. PARKS, M. D., A PROFESSIONAL MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-07",
        "last_updated": "2009-08-06",
        "status": "A",
        "authorized_official_last_name": "PARKS",
        "authorized_official_first_name": "KERRI",
        "authorized_official_middle_name": "SHANE",
        "authorized_official_title_or_position": "PRESIDENT/ M.D.",
        "authorized_official_telephone_number": "818-952-5322",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0102260",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kent W Small, MD a Medical Corporation
• Julie Dawn Kenworth-Caragio, LMFT
• Maral Keosseian
• Freda Kerikorian
• Lida Kerobyan
• Ramesh C. Kesavalu, M.D.
• Naris Kesheshe
• Adrineh Keshish
• Jasmen Keshishean
• Arpineh Keshishian, LCSW

• Specialist in Glendale, CA
• Providers in Glendale, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2009; 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.