Chong Min Park, MD

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

MD428499 Issued in PA

Practice address

24 Doctors LN
Suite 304
Clarion, PA 16214-8568

Phone

(814) 226-7800

Fax

(814) 226-7801

NPI assigned

Jul 8, 2005

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1120780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1231113600000",
    "number": "1992703409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 DOCTORS LN",
            "address_2": "SUITE 304",
            "city": "CLARION",
            "state": "PA",
            "postal_code": "162148568",
            "telephone_number": "814-226-7800",
            "fax_number": "814-226-7801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 DOCTORS LN",
            "address_2": "SUITE 304",
            "city": "CLARION",
            "state": "PA",
            "postal_code": "162148568",
            "telephone_number": "814-226-7800",
            "fax_number": "814-226-7801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "CHONG",
        "middle_name": "MIN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-08",
        "last_updated": "2009-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "PA",
            "license": "MD428499",
            "primary": true
        },
        {
            "code": "207XS0106X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Hand Surgery",
            "state": "PA",
            "license": "MD428499",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary J Obenreder, LDN
• Yuliia Oliinyk, MD
• Michelle Olson Hutchins, CNM
• Kari Overheim, CRC, LPC
• Kelly L Owens, O.D.
• Stephanie Pasquarette, CRNP
• Carmen Danielle Pastor, MS, LAT, ATC
• Peace Dental Associates
• Penn Traffic Co
• Pennsylvania CVS Pharmacy, L.L.C.

• All providers in Clarion, PA
• Orthopaedic Surgery Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 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.