DR. SAMUEL PARK (NPI# 1205222510) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205222510 |
| Entity Type | Individual |
| Full Name | DR. SAMUEL PARK |
| Credential | PHD |
| Practice Address |
1201 Broad Rock Blvd Richmond VA 23249-0001 |
| Practice Telephone | 8046755000 |
| Mailing Telephone | 8046755000 |
| Enumeration Date | 2015-04-13 |
| Last Update Date | 2019-07-25 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
0810005121 | VA | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922363183 | Samuel Park | Preventive Medicine | 2448 Historic Decatur Rd Ste 130, San Diego, CA 92106-6127 | 2012-07-12 |
| 1053607952 | Samuel Joon Park | Internal Medicine | 160 1st St Unit 551, Mineola, NY 11501-5025 | 2011-06-20 |
| 1851504377 | Samuel Sanghong Park | Orthopaedic Surgery | 12 Salt Creek Ln Ste 350, Hinsdale, IL 60521-8612 | 2007-05-08 |
| 1023174752 | Samuel Ryan Park | Anesthesiology | 22 Odyssey Ste 155, Irvine, CA 92618-3194 | 2006-12-28 |
| 1497832661 | Samuel K. Park | Family Medicine | 20072 Sw Birch St Ste 100, Newport Beach, CA 92660-0794 | 2006-11-01 |
| 1740285907 | Samuel Mo Park | Physical Medicine & Rehabilitation | 340 W East Ave, Chico, CA 95926-7238 | 2005-06-15 |
| 1124551239 | Samuel Park | Student in an Organized Health Care Education/Training Program | 1959 Ne Pacific St, Bb-1469, Seattle, WA 98195-0001 | 2017-04-05 |
| 1154853836 | Samuel Park | Physical Therapist | 5000 W National Ave, Milwaukee, WI 53295-0001 | 2017-03-31 |
| 1790237899 | Samuel Park | Student in an Organized Health Care Education/Training Program | 3580 Wilshire Blvd Fl 8, Los Angeles, CA 90010-2505 | 2016-10-25 |
| 1295187136 | Samuel Park IIi | Physical Medicine & Rehabilitation | 1240 Mckee Rd, Dover, DE 19904-1381 | 2016-07-03 |
| Street Address |
1201 BROAD ROCK BLVD |
| City | RICHMOND |
| State | VA |
| Zip Code | 23249-0001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780684480 | Earl M. Rogers I | Pharmacist | 1201 Broad Rock Blvd, Vamc Pharmacy Svc (119), Richmond, VA 23249-0001 | 2005-07-26 |
| 1750981791 | Irene Julia Montero | Recreation Therapist | 1201 Broad Rock Blvd, Richmond, VA 23249-0001 | 2020-10-29 |
| 1194325068 | Rodrick Dewayne Shinholster | Recreation Therapist | 1201 Broad Rock Blvd, Richmond, VA 23249-0001 | 2020-10-29 |
| 1902406887 | Akia Johnson | Recreation Therapist | 1201 Broad Rock Blvd, Richmond, VA 23249-0001 | 2020-10-29 |
| 1982204285 | Shaquana Shanesea Jones | Kinesiotherapist | 1201 Broad Rock Blvd, Richmond, VA 23249-0001 | 2020-10-27 |
| 1396345773 | Freda Sergi | Recreation Therapist | 1201 Broad Rock Blvd, Richmond, VA 23249-0001 | 2020-10-27 |
| 1548860091 | Curtis Antoine Robb | Recreation Therapist | 1201 Broad Rock Blvd, Richmond, VA 23249-0001 | 2020-10-26 |
| 1891394326 | Paulette Suzanne Beasley | Recreation Therapist | 1201 Broad Rock Blvd, Richmond, VA 23249-0001 | 2020-10-26 |
| 1104425636 | Jennifer Lee Vass | Recreation Therapist | 1201 Broad Rock Blvd, Richmond, VA 23249-0001 | 2020-10-26 |
| 1760099204 | Caitlyn Andree Pittman | Kinesiotherapist | 1201 Broad Rock Blvd, Richmond, VA 23249-0001 | 2020-09-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184010407 | Chris Dinh Nguyen | Internal Medicine | 1201 Broad Rock Blvd Richmond, Richmond, VA 23249 | 2015-04-14 |
| 1982049425 | Amy Nicole Whiffin | Emergency Medicine | 1201 Broad Rock Blvd. Emergency Department, Richmond, VA 23249 | 2013-05-09 |
| 1770786311 | Katherine Martin | Dentist | Mcguire Vamc Dental Service 1201 Broad Rock Blvd, Richmond, VA 23249 | 2007-06-11 |
| 1407922214 | Thomas Fagan | Pharmacist | 1201 Broadwalk Blvd, Richmond, VA 23249 | 2006-11-27 |
| 1922197474 | Rufus Anthony Harris | Social Worker | 1201 Broadrock Boulevard, Room 1e 114, Richmond, VA 23249 | 2006-10-12 |
| 1497848386 | Patricia S Kelly | Religious Nonmedical Nursing Personnel | 1201 Brock Roack Blvd., Richmond, VA 23249 | 2006-10-02 |
| 1073619938 | Deborah Walck Haynes | Physician Assistant | Mcguire Va Medical Center, 1201 Broad Rock Blvd. (151), Richmond, AL 23249 | 2006-09-16 |
| 1932204682 | James Kenneth Schmitt | Internal Medicine | 1201 Broadrock Rd, Richmond, VA 23249 | 2006-09-14 |
| 1679675045 | Ida Foster | Family Medicine | 1801 Broad Rock Boulevard, Richmond, VA 23249 | 2006-09-05 |
| 1871607176 | James Luther Tatum | Nuclear Medicine | 1201 Broadrock Road, Richmond, VA 23249 | 2006-08-17 |
| Find all providers in zip 23249 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144796731 | A Step Forward Wellness Services LLC | Psychologist | 2002 Bremo Rd Ste 204, Richmond, VA 23226-2441 | 2018-10-22 |
| 1417435447 | Erin D. Kurtz | Psychologist | 1201 Broad Rock Blvd # 116b, Richmond, VA 23249-0001 | 2018-08-01 |
| 1649762873 | Caitlin Paige Campbell | Psychologist | 1201 Brock Road Blvd, Richmond, VA 23249-0001 | 2018-06-04 |
| 1689195141 | Kimberly Knight Hilton | Psychologist | 2401 Hartman St, Richmond, VA 23223-2458 | 2017-07-05 |
| 1720511504 | Marshall Psychological Services, LLC | Psychologist | 2800 N. Parham Road, Suite 107, Richmond, VA 23294 | 2017-04-07 |
| 1740732981 | Howard Lloyd | Psychologist | 907 Floyd Ave, Richmond, VA 23284-9026 | 2016-11-03 |
| 1679929061 | Elizabeth Meghan Archer Wheeler | Psychologist | 7400 Beaufort Springs Drive, Suite 300, Richmond, VA 23225-3039 | 2016-05-04 |
| 1730558909 | Jodi Suzanne Couick | Psychologist | 3000 Parker Rd, Richmond, CA 94806-2742 | 2015-09-17 |
| 1386024461 | Rosalie Corona | Psychologist | 4730 East Southside Plaza, Richmond, VA 23224 | 2015-06-04 |
| 1649677337 | Yuriy Ustinov | Psychologist | 3 Baker St, Richmond, ME 04357-1387 | 2014-11-25 |
| Find all providers in RICHMOND | ||||
Please comment or provide details below to improve the information on DR. SAMUEL PARK.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.