PARK MEDICAL CLINIC
NPI 1831710623
Family Medicine in Pontotoc, MS
About Park Medical Clinic NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
PARK MEDICAL CLINIC (NPI 1831710623) is a healthcare organization registered as a family medicine in Pontotoc, Mississippi and active in the NPI registry since May 2020. The organization holds a CLIA Waiver certificate valid through May 20, 2028 and lists Christopher Park, Owner/physician, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Group Practice 1
Accepted Insurance
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 Medical Clinic is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
2Medicare enrollment records show 2 clinicians reassign Medicare billing to Park Medical Clinic, which bills Medicare for the services they deliver. Of these, 1 practice at this address. They are listed nearest first.
Clinicians, nearest first (2)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 25D2184536
Chris Park Do PC Dba Park Medical Clinic · Pontotoc, MSFrequently 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 Chris Park Do PC's NPI number?
The NPI number for Chris Park Do PC is 1831710623. It was assigned to this organization in the NPPES registry on May 3, 2020. The provider is doing business as Park Medical Clinic.
Where is Chris Park Do PC located?
Chris Park Do PC is located at 47 S Main St, Pontotoc, MS 38863. The listed phone number is (662) 499-2802.
What is Chris Park Do PC's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Chris Park Do PC enrolled in Medicare?
Yes. Chris Park Do PC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Chris Park Do PC?
According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians reassign their Medicare billing to Chris Park Do PC, in Family Practice and Nurse Practitioner. 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, 1 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Chris Park Do PC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 25D2184536) is associated with this NPI, valid through May 20, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Chris Park Do PC accept?
Health plans from Ambetter Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter of Alabama and Ambetter of Tennessee and 1 other insurer list Chris Park Do PC 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 Chris Park Do PC was last updated on February 18, 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.
# Park Medical Clinic · NPI 1831710623
Family Medicine organization in Pontotoc, Mississippi. Organization record, active in the CMS NPPES registry since May 3, 2020.
## Identity
- **NPI:** 1831710623 (Entity type: Organization)
- **Enumerated:** May 3, 2020
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **Legal business name:** Chris Park Do Pc
- **Organization subpart:** No
- **Authorized official:** Christopher Park, OWNER/PHYSICIAN
## Practice location
- **Address:** 47 S MAIN ST, Pontotoc, MS 38863-2823
- **Phone:** (662) 499-2802
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 2 clinicians in 2 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Family Practice (1), Nurse Practitioner (1); 1 practice at this address · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** February 18, 2024
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1831710623) · Data from the CMS NPPES public registry.