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JENNIE HAELYNN PARK MD
NPI 1821889775
Obstetrics & Gynecology in Augusta, GA

Active since May 12, 2025PECOS Enrolled
1459 LANEY WALKER BLVD, AUGUSTA, GA 30912(706) 721-2541 Get Directions Write a Review

NPPES record last updated: May 12, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Jennie Haelynn Park Md NPPES

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

JENNIE HAELYNN PARK MD (NPI 1821889775) is an individual obstetrics & gynecology provider in Augusta, Georgia, licensed in Georgia (17618) and active in the NPI registry since May 2025. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1821889775
Entity TypeIndividualFemale
Primary Taxonomy207V00000X
Provider Legal NameJENNIE HAELYNN PARKCredential: MD
Location Address1459 LANEY WALKER BLVDAugusta, GA 30912-0002
Mailing Address1459 Laney Walker BlvdAugusta, GA 30912-0002
Phone(706) 721-2541
Sole ProprietorNo
Enumeration DateMay 12, 2025
NPPES CertifiedMay 12, 2025
✔ NPI 1821889775 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyObstetrics & GynecologyAllopathic & Osteopathic Physicians
Taxonomy Code207V00000X
License✔ Licensed in GA · 17618
Definition
An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.
1459 LANEY WALKER BLVD, Augusta, GA 30912
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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)

Jennie Haelynn 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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30912 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
$124.10 typical visit price
range $53.31 – $164.04
Typical copayment $31.02 (range $13.32 – $41.01)
Most-billed visit code 99204
Established Patient
$66.89 typical visit price
range $16.68 – $133.24
Typical copayment $16.72 (range $4.17 – $33.31)
Most-billed visit code 99213
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. STEVEN KENT NELSON DMD
Dentist (Prosthodontics)
1459 LANEY WALKER BLVD, AD1501
AUGUSTA, GA 30912
Richmond County (706) 721-0502
BRANDOL WOLFENBARGER
Pathology (Anatomic Pathology & Clinical Pathology)
1459 LANEY WALKER BLVD
AUGUSTA, GA 30912
Richmond County (706) 721-7005
DR. EDNA L PASHLEY DMD
Dentist (Pediatric Dentistry)
1459 LANEY WALKER BLVD, AD1501
AUGUSTA, GA 30912
Richmond County (706) 721-0502
WILLIAM HAINSWORTH TREDWELL MD
Student in an Organized Health Care Education/Training Program
1459 LANEY WALKER BLVD
AUGUSTA, GA 30912
Richmond County (757) 668-7249
NEVA BIANCA HOPE DO
Emergency Medicine
1459 LANEY WALKER BLVD, AE 3046
AUGUSTA, GA 30912
Richmond County (706) 721-7005
ZACHARY MASSEY MD
Anesthesiology
1459 LANEY WALKER BLVD
AUGUSTA, GA 30912
Richmond County (706) 721-7005
DR. HUSSEIN KHARROUBI MD
Surgery
1459 LANEY WALKER BLVD
AUGUSTA, GA 30912
Richmond County (706) 721-7005
DR. AHMED KHOCHT DDS
Dentist (Periodontics)
1459 LANEY WALKER BLVD, AD1501
AUGUSTA, GA 30912
Richmond County (706) 721-0502

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 Jennie Park's NPI number?

The NPI number for Jennie Park is 1821889775. It was assigned to this individual provider in the NPPES registry on May 12, 2025.

Where is Jennie Park located?

Jennie Park practices at 1459 Laney Walker Blvd, Augusta, GA 30912. The listed phone number is (706) 721-2541.

What is Jennie Park's specialty?

The primary specialty registered for this NPI is Obstetrics & Gynecology with taxonomy code 207V00000X.

Is Jennie Park enrolled in Medicare?

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

When was this NPI record last updated?

The NPPES record for Jennie Park was last updated on May 12, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.