Shannon Parks, DO

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

25MB08705600 Issued in NJ

Practice address

55 N Gilbert St Ste 1103
Tinton Falls, NJ 07701-4956

Phone

(732) 447-2545

NPI assigned

Jul 7, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Apr 1, 2016 through Apr 1, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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 and National Provider Directory roles.

• Dr. Shannon Parks D.O. LLC

  • Psychiatry Physician
  • Tinton Falls, NJ
  • NPI 1235935362
  NPD Authorized official

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

{
    "created_epoch": "1246924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725580800000",
    "number": "1962631457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 N GILBERT ST STE 1103",
            "city": "TINTON FALLS",
            "state": "NJ",
            "postal_code": "077014956",
            "telephone_number": "732-447-2545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 N GILBERT ST STE 1103",
            "city": "TINTON FALLS",
            "state": "NJ",
            "postal_code": "077014956",
            "telephone_number": "732-447-2545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARKS",
        "first_name": "SHANNON",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-07",
        "last_updated": "2024-09-06",
        "certification_date": "2024-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NJ",
            "license": "25MB08705600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy Elizabeth Olson, DNP
• Opmc, LLC.
• Jenny L Orwick, BCBA
• Wesley Ostrzycki, DPT, ATC
• Gregory Parker, MD
• Neha J Pathak, DPM
• Peace Acupuncture Clinic LLC
• Leeann J. Pearce-Woolley, A.T.C
• Jonathan Daniel Pearlson, PSY.D.
• Linda Marie Valas Pedro, DVM

• Psychiatry Physician in Tinton Falls, NJ
• Providers in Tinton Falls, NJ by specialty
• Psychiatry Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.