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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

PARK MEDICAL
NPI 1124737408
Clinic/Center - Rural Health in Whitwell, TN

Active since November 16, 2022CLIA 44D0871248 · Waiver
13851 HIGHWAY 28, WHITWELL, TN 37397(423) 658-9200(423) 658-2195 Get Directions Write a Review

NPPES record last updated: July 21, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 21, 2026, Mar 17, 2025, Oct 9, 2023 and 3 more (6 updates tracked since 2022).

About Park Medical NPPES

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

PARK MEDICAL (NPI 1124737408) is a healthcare organization registered as a rural health in Whitwell, Tennessee and active in the NPI registry since November 2022. The organization holds a CLIA Waiver certificate valid through February 9, 2028 and lists James Kennedy, Owner, as its authorized official.

NPPES Registry Identity

NPI1124737408
Entity TypeOrganization
Primary Taxonomy261QR1300X
Legal Business NamePARK MEDICAL
Location Address13851 HIGHWAY 28Whitwell, TN 37397-5373
Mailing Address13851 Highway 28Whitwell, TN 37397-5373 · (423) 658-9200 · Fax (423) 658-2195
Phone(423) 658-9200
Fax(423) 658-2195
Organization SubpartNo
Authorized OfficialJames KennedyOwner · (423) 658-9200
Enumeration DateNovember 16, 2022
Last NPPES UpdateJuly 21, 20266 updates tracked since enumeration
NPPES CertifiedJuly 21, 2026
✔ NPI 1124737408 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyClinic/Center · Rural HealthAmbulatory Health Care Facilities
Taxonomy Code261QR1300X
Also ListedFamily MedicineTaxonomy 207Q00000X
13851 HIGHWAY 28, Whitwell, TN 37397
Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Magnolia Health and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 44D0871248

Park Medical, LLC · Whitwell, TN
Active · expires Feb 9, 2028
CLIA Number44D0871248
Laboratory TypePhysician Office
Certificate Effective DateFebruary 10, 2026
Certificate Expiration DateFebruary 9, 2028
Laboratory DirectorCharlie Fang
Laboratory Phone(423) 658-9200
Laboratory LocationPark Medical, LLC13851 Hwy 28, Whitwell, TN 37397
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 8

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

STEVEN S TODD LADC
Counselor (Addiction (Substance Use Disorder))
13851 HIGHWAY 28
WHITWELL, TN 37397
Marion County (423) 658-9200
BRENDA ROSS MD PC
Family Medicine
13851 HIGHWAY 28
WHITWELL, TN 37397
Marion County (423) 658-9200
WHITWELL MEDICAL PLAZA
Clinic/Center (Primary Care)
13851 HIGHWAY 28
WHITWELL, TN 37397
Marion County (423) 658-9200
MICHELLE DENISE GULLEY FNP-C
Nurse Practitioner (Family)
13851 HIGHWAY 28
WHITWELL, TN 37397
Marion County (423) 658-9200
KIMBERLY GEAN REDFEARN NP-C
Nurse Practitioner (Family)
13851 HIGHWAY 28
WHITWELL, TN 37397
Marion County (423) 658-9200
DR. ALAN DEWITT KENNETT KELLEY MD
Family Medicine
13851 HIGHWAY 28
WHITWELL, TN 37397
Marion County (423) 658-9200
CHARLIE WEICHIN FANG MD
Family Medicine
13851 HIGHWAY 28
WHITWELL, TN 37397
Marion County (423) 653-9210
MR. JUNG TAE PARK MD
Family Medicine (Adult Medicine)
13851 HIGHWAY 28
WHITWELL, TN 37397
Marion County (423) 658-9200

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Park Medical's NPI number?

The NPI number for Park Medical is 1124737408. It was assigned to this organization in the NPPES registry on November 16, 2022.

Where is Park Medical located?

Park Medical is located at 13851 Highway 28, Whitwell, TN 37397. The listed phone number is (423) 658-9200.

What is Park Medical's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Rural Health, with taxonomy code 261QR1300X.

Does Park Medical hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 44D0871248) is associated with this NPI, valid through February 9, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Park Medical accept?

Health plans from Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Magnolia Health, Ambetter of Alabama and Ambetter of North Carolina and 2 other insurers list Park Medical as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Park Medical was last updated on July 21, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 21 days 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.