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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.

DR. CHEON GYU PARK D.C.
NPI 1649699109
Chiropractor in Fairfax, VA

Active since April 14, 2014
3900 UNIVERSITY DR STE 100, FAIRFAX, VA 22030(571) 513-7070(571) 556-7075 Get Directions Write a Review

NPPES record last updated: October 20, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Nov 17, 2023, Jan 25, 2017 (2 updates tracked since 2017).

About Dr. Cheon Gyu Park D.c. NPPES

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

DR. CHEON GYU PARK D.C. (NPI 1649699109) is an individual chiropractor in Fairfax, Virginia, licensed in Virginia (0104557163) and active in the NPI registry since April 2014. He is a graduate of Palmer College Chiropractic - Davenport (2013).

NPPES Registry Identity

NPI1649699109
Entity TypeIndividualMale
Primary Taxonomy111N00000X
Provider Legal NameDR. CHEON GYU PARKCredential: D.C.
Location Address3900 UNIVERSITY DR STE 100Fairfax, VA 22030-2513
Mailing Address3900 University Dr Ste 100Fairfax, VA 22030-2513 · (571) 513-7070 · Fax (571) 556-7075
Phone(571) 513-7070
Fax(571) 556-7075
Sole ProprietorNo
Medical School CMSPalmer College Chiropractic - DavenportGraduated 2013
Enumeration DateApril 14, 2014
Last NPPES UpdateOctober 20, 20262 updates tracked since enumeration
NPPES CertifiedOctober 20, 2026
✔ NPI 1649699109 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyChiropractorChiropractic Providers
Taxonomy Code111N00000X
License✔ Licensed in VA · 0104557163
Definition
A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.
3900 UNIVERSITY DR STE 100, Fairfax, VA 22030
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Cheon Gyu Park D.c. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID7012270119
PECOS Enrollment IDI20240304002796

Medicare Billing Reassignments

2

Medicare enrollment records show Cheon Gyu Park reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Ultimate Spine Health & Chiropractic
Same address
Chiropractor
3900 UNIVERSITY DR STE 100
Fairfax, VA 22030
  • Reassigned Medicare billing, District of Columbia enrollment
NPI 1376318519 (571) 513-7070
Chiropractic Works2 LLC
54 mi
Chiropractor
1102 E JOPPA RD
Towson, MD 21286
  • Reassigned Medicare billing, Maryland enrollment
  • 3 clinicians in this Medicare group
NPI 1326550419 (410) 321-7210

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

Other Providers at the Same Location NPPES

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

ULTIMATE SPINE HEALTH & CHIROPRACTIC
Chiropractor
3900 UNIVERSITY DR STE 100
FAIRFAX, VA 22030
Fairfax City (571) 513-7070

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 Cheon Gyu Park's NPI number?

The NPI number for Cheon Gyu Park is 1649699109. It was assigned to this individual provider in the NPPES registry on April 14, 2014.

Where is Cheon Gyu Park located?

Cheon Gyu Park practices at 3900 University Dr Ste 100, Fairfax, VA 22030. The listed phone number is (571) 513-7070.

What is Cheon Gyu Park's specialty?

The primary specialty registered for this NPI is Chiropractor with taxonomy code 111N00000X.

Is Cheon Gyu Park enrolled in Medicare?

Yes. Cheon Gyu Park is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Cheon Gyu Park's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Cheon Gyu Park reassigns Medicare benefits to 2 organizations: Ultimate Spine Health & Chiropractic (Fairfax, VA) and Chiropractic Works2 LLC (Towson, MD). Each 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 Cheon Gyu Park's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Cheon Gyu Park was last updated on October 20, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.