DR. JEANIE PARK M.D.
NPI 1043409048
Internal Medicine - Nephrology in Atlanta, GA

Q: What is Jeanie Park's NPI number?

The NPI number for Jeanie Park is 1043409048. It was assigned to this individual provider in the NPPES registry on October 16, 2007.

Q: What is Jeanie Park's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Nephrology, with taxonomy code 207RN0300X.

Q: When was this NPI record last updated?

The NPPES record for Jeanie Park was last updated on May 17, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since October 16, 2007PECOS Enrolled

550 PEACHTREE ST NE, MOT 8TH FLOOR, ATLANTA, GA 30308(404) 686-5038(404) 686-4995 Get Directions Write a Review

NPPES record last updated: May 17, 2011. Verified against the NPPES registry weekly; last sync: August 02, 2026.

On this page

About Dr. Jeanie Park M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. JEANIE PARK M.D. (NPI 1043409048) is an individual nephrology provider in Atlanta, Georgia, licensed in Georgia (061137) and active in the NPI registry since October 2007. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1043409048

Entity TypeIndividualFemale

Primary Taxonomy207RN0300X

Provider Legal NameDR. JEANIE PARKCredential: M.D.

Location Address550 PEACHTREE ST NE, MOT 8TH FLOORAtlanta, GA 30308-2208

Mailing Address1670 Clairmont Rd, Renal/nephrology And Hemodialysis Med (111)Decatur, GA 30033-4004 · (404) 321-6111 · Fax (404) 235-3049

Phone(404) 686-5038

Fax(404) 686-4995

Sole ProprietorNo

Enumeration DateOctober 16, 2007

Last NPPES UpdateMay 17, 2011

✔ NPI 1043409048 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · NephrologyAllopathic & Osteopathic Physicians

Taxonomy Code207RN0300X

License✔ Licensed in GA · 061137

Definition

An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation.

550 PEACHTREE ST NE, Atlanta, GA 30308

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Jeanie Park M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30308 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$130.64 typical visit price

range $56.84 – $172.43

Typical copayment $32.66 (range $14.21 – $43.10)

Most-billed visit code 99204

Established Patient

$100.20 typical visit price

range $18.22 – $140.40

Typical copayment $25.05 (range $4.55 – $35.10)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. DOMINIC JOSEPH PAPANDRIA M.D.

Surgery