NPIMap

Individual provider Active NPI

John Tice Parks, MD

  • Family Medicine Physician
  • Washington, DC
National Provider Identifier
1942528518
Registry record updated Jul 31, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD041594 Issued in DC
Practice address
3924 Minnesota Ave. NE
Unity Healthcare - Minnesota Avenue Clinic
Washington, DC 20019
Phone
(202) 398-8683
Fax
(202) 627-7815
NPI assigned
May 6, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD041594 DC Primary
Student in an Organized Health Care Education/Training Program 390200000X 164607 NC

Addresses

Primary practice location

3924 Minnesota Ave. NE
Unity Healthcare - Minnesota Avenue Clinic
Washington, DC 20019

Mailing address

3924 Minnesota Ave. NE
Unity Healthcare - Minnesota Avenue Clinic
Washington, DC 20019
Phone (202) 398-8683

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR, MS2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20211115000466 AR Practitioner - Family Practice 5890923361 Reassigns benefits to 3 organizations
I20220517000845 MS Practitioner - Family Practice 5890923361 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Georgetown University School of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lake Village Clinic PAGroup PAC ID 3274575162, 8 clinicians

Practice addresses (Care Compare)

2918 Louis Sessions
Lake Village, AR 71653-6049

2918 Louis Sessions St
Lake Village, AR 71653-6049
Phone (870) 265-5343

Hospital & facility affiliations

  • Chicot Memorial Medical Center Home Health Agenc Home health agency, Lake Village, AR, CCN 047104
  • Chicot Memorial Medical Center Hospital, Lake Village, AR, CCN 041328
  • Delta Health System - the Medical Center Hospital, Greenville, MS, CCN 250082
  • Southeast Rehabilitation Hospital Inpatient rehabilitation facility, Lake Village, AR, CCN 043034
  • Chicot Memorial Medical Center Nursing home, CCN 04Z328

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
164607NCMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Arkansas Emergency Staffing Solutions, Inc CurrentSince Jul 20, 2022 Accepting new patients
Delta Medical Group Family Medicine CurrentSince Mar 1, 2022 Accepting new patients
Lake Village Clinic PA CurrentSince Nov 1, 2021 Accepting new patients
Delta Physician Practices Past Accepting new patients

Locations

1015 Unity Rd
Crossett, AR 71635
Phone (870) 364-0590

2918 Louis Sessions St
Lake Village, AR 71653
Phone (870) 265-5343

2729 S Highway 65 82
Lake Village, AR 71653
Phone (870) 265-5351

1400 E Union St
Greenville, MS 38703
Phone (601) 427-0422

1693 Fairgrounds Rd
Greenville, MS 38703
Phone (662) 378-3783

Interoperability endpoints

  • Direct secure messaging: john.parks@lvcp.eclinicaldirectplus.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/HCCAAA

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 11

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1273104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375228800000",
    "number": "1942528518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3924 MINNESOTA AVE. NE",
            "address_2": "UNITY HEALTHCARE - MINNESOTA AVENUE CLINIC",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "20019",
            "telephone_number": "202-398-8683",
            "fax_number": "202-627-7815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3924 MINNESOTA AVE. NE",
            "address_2": "UNITY HEALTHCARE - MINNESOTA AVENUE CLINIC",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "20019",
            "telephone_number": "202-398-8683",
            "fax_number": "202-627-7815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARKS",
        "first_name": "JOHN",
        "middle_name": "TICE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-05-06",
        "last_updated": "2013-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "DC",
            "license": "MD041594",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NC",
            "license": "164607",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

Verify at the official NPI Registry.