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PARK PLASTIC SURGERY, P.A.
NPI 1265533806
Specialist in Rocky Mount, NC

Active since September 26, 2006
4008 CAPITAL DR, ROCKY MOUNT, NC 27804(252) 937-5003(252) 937-3020 Get Directions Write a Review

NPPES record last updated: January 7, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Park Plastic Surgery, P.a. NPPES

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

PARK PLASTIC SURGERY, P.A. (NPI 1265533806) is a healthcare organization registered as a specialist in Rocky Mount, North Carolina and active in the NPI registry since September 2006. The organization lists Frederick K. Park, Owner, as its authorized official.

NPPES Registry Identity

NPI1265533806
Entity TypeOrganization
Primary Taxonomy174400000X
Legal Business NamePARK PLASTIC SURGERY, P.A.
Location Address4008 CAPITAL DRRocky Mount, NC 27804-3123
Mailing AddressPo Box 13219Durham, NC 27709-3219 · (252) 937-5003 · Fax (252) 937-3020
Phone(252) 937-5003
Fax(252) 937-3020
Organization SubpartNo
Authorized OfficialFrederick K. ParkOwner · (252) 937-5003
Enumeration DateSeptember 26, 2006
Last NPPES UpdateJanuary 7, 2026
NPPES CertifiedJanuary 7, 2026
✔ NPI 1265533806 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
License✔ Licensed in NC · 36793
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
4008 CAPITAL DR, Rocky Mount, NC 27804
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Other Identifiers 1

Medicaid1265533806NC

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Park Plastic Surgery, P.a. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

2

Medicare enrollment records show 2 clinicians reassign Medicare billing to Park Plastic Surgery, P.A., which bills Medicare for the services they deliver. Of these, 2 practice at this address. They are listed nearest first.

Clinicians, nearest first (2)

Frederick Park, M.D.
Plastic and Reconstructive Surgery
NPI 1407964547
4008 CAPITAL DRIVE
Rocky Mount, NC 27804
(252) 937-5003
✔ PECOS✔ Accepts MedicareSame address
Susan Everette, RN, MSN, FNP
Nurse Practitioner
NPI 1730291923
4008 CAPITAL DRIVE
Rocky Mount, NC 27804
(252) 937-5003
✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Plastic Surgery, P.A.'s NPI number?

The NPI number for Park Plastic Surgery, P.A. is 1265533806. It was assigned to this organization in the NPPES registry on September 26, 2006.

Where is Park Plastic Surgery, P.A. located?

Park Plastic Surgery, P.A. is located at 4008 Capital Dr, Rocky Mount, NC 27804. The listed phone number is (252) 937-5003.

What is Park Plastic Surgery, P.A.'s specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

Is Park Plastic Surgery, P.A. enrolled in Medicare?

Yes. Park Plastic Surgery, P.A. is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Park Plastic Surgery, P.A.?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians reassign their Medicare billing to Park Plastic Surgery, P.A., in Nurse Practitioner and Plastic and Reconstructive Surgery. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 2 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Park Plastic Surgery, P.A. was last updated on January 7, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 months 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.