DR. JOHN J W PARK MD
NPI 1205687209
Student in an Organized Health Care Education/Training Program in Durham, NC

Active since March 28, 2024PECOS Enrolled
2301 ERWIN RD, DURHAM, NC 27705(919) 684-8111 Get Directions Write a Review

NPPES record last updated: March 28, 2024. Verified against the NPPES registry weekly; last sync: August 30, 2026.

About Dr. John J W Park Md NPPES

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

DR. JOHN J W PARK MD (NPI 1205687209) is an individual student in an organized health care education/training program in Durham, North Carolina and active in the NPI registry since March 2024. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1205687209
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameDR. JOHN J W PARKCredential: MD
Location Address2301 ERWIN RDDurham, NC 27705-4699
Mailing Address2301 Erwin RdDurham, NC 27705-4699 · (919) 684-8111
Sole ProprietorYes
Enumeration DateMarch 28, 2024
NPPES CertifiedMarch 28, 2024
NPI 1205687209 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
2301 ERWIN RD, Durham, NC 27705

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. John J W Park Md 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.

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.

Radiology (Diagnostic Radiology)
2301 ERWIN RD
DURHAM, NC 27705
Psychiatry & Neurology (Psychiatry)
2301 ERWIN RD
DURHAM, NC 27705
Anesthesiology
2301 ERWIN RD
DURHAM, NC 27705
Student in an Organized Health Care Education/Training Program
2301 ERWIN RD
DURHAM, NC 27705
Nurse Practitioner (Family)
2301 ERWIN RD
DURHAM, NC 27705
Psychiatry & Neurology (Neurology)
2301 ERWIN RD
DURHAM, NC 27705
Surgery (Vascular Surgery)
2301 ERWIN RD
DURHAM, NC 27705
Emergency Medicine
2301 ERWIN RD
DURHAM, NC 27705

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 John Park's NPI number?

The NPI number for John Park is 1205687209. It was assigned to this individual provider in the NPPES registry on March 28, 2024.

Where is John Park located?

John Park practices at 2301 Erwin Rd, Durham, NC 27705. The listed phone number is (919) 684-8111.

What is John Park's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is John Park enrolled in Medicare?

Yes. John Park is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for John Park was last updated on March 28, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.