ROGER TIMOTHY PARK (NPI# 1295713444) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295713444 |
| Entity Type | Individual |
| Full Name | ROGER TIMOTHY PARK |
| Credential | DO |
| Practice Address |
2501 Capehart Rd Offutt A F B NE 68113-1043 |
| Mailing Address |
2309 Marilyn Dr Papillion NE 68046-4218 |
| Practice Telephone | 4022942056 |
| Mailing Telephone | 4025934041 |
| Enumeration Date | 2006-01-06 |
| Last Update Date | 2013-10-04 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 5301 | NE | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033415344 | Roger William Park | Pediatrics | 7676 Overland Trail, Delaware, OH 43015-8318 | 2011-02-03 |
| 1174623409 | Roger W Park | Internal Medicine | 1000 N Oak Ave, Marshfield, WI 54449-5703 | 2006-09-25 |
| Street Address |
2501 CAPEHART RD |
| City | OFFUTT A F B |
| State | NE |
| Zip Code | 68113-1043 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841562212 | Kendra Lynn Haynes | Dental Hygienist | 2501 Capehart Rd, Offutt A F B, NE 68113-1043 | 2012-02-01 |
| 1275816902 | Jeremy Lee Hurst | Nurse Practitioner | 2501 Capehart Rd, Offutt A F B, NE 68113-1043 | 2011-09-20 |
| 1568758746 | Daniel Joseph Binkowski | Dentist | 2501 Capehart Rd, Offutt A F B, NE 68113-1043 | 2011-06-25 |
| 1427355866 | Andrea Jefferson | Military Health Care Provider | 2501 Capehart Rd, Offutt A F B, NE 68113-1043 | 2011-02-22 |
| 1447553169 | Jeffrey Grant Larkin | Dentist | 2501 Capehart Rd, Offutt A F B, NE 68113-1043 | 2010-12-20 |
| 1629309109 | Miriam E Flack | Dietitian, Registered | 2501 Capehart Rd, Offutt A F B, NE 68113-1043 | 2010-01-22 |
| 1194954412 | Molly Claire Goessling | Pharmacist | 2501 Capehart Rd, Offutt A F B, NE 68113-1043 | 2009-07-08 |
| 1447486253 | Aaron Michael Wulff | Dentist | 2501 Capehart Rd, Offutt A F B, NE 68113-1043 | 2009-06-08 |
| 1407082522 | Claude Alan Russo | Military Health Care Provider | 2501 Capehart Rd, Sgopf, Offutt A F B, NE 68113-1043 | 2009-06-03 |
| 1245465137 | Gregory Royce Beavers | Military Health Care Provider | 2501 Capehart Rd, Offutt A F B, NE 68113-1043 | 2009-05-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386133668 | Peter Mitchell Martin | Family Medicine | Offutt Afb Family Medicine Residency, 2501 Capehart Rd., Offutt Afb, NE 68113 | 2018-05-02 |
| 1619212792 | Tyrone Antonio Simon | Social Worker | 2501 Capehart Rd Bldg 4000, Offutt Afb, NE 68113 | 2012-11-30 |
| 1245536994 | Aaron Bradley Smith | Military Health Care Provider | Ehrling Bergquist Clinic, 2501 Capehart Rd, Offutt Afb, NE 68113 | 2011-01-28 |
| 1962719294 | Amy Elaine Klein | Optometrist | 106 Meyer Ave, Bldg 166, Offutt Afb, NE 68113 | 2010-09-08 |
| 1720248974 | Americas Best Contacts & Eyeglasses | Technician/Technologist | Bldg 166 Offutt Afb Exchange, Offutt Afb, NE 68113 | 2008-06-11 |
| 1548343296 | Jack David Wright | Pharmacist | 2501 Capehart, Erhling Bergquist Hospital, Offutt Afb, NE 68113 | 2006-10-23 |
| 1215023890 | Mark James Angerbauer | Dentist | 2501 Capehart Rd., Omaha, NE 68113 | 2006-10-04 |
| 1003915430 | 55th Medical Group Sgsl | Pharmacy | Bldg 107 Rm 101, Offutt, NE 68113 | 2006-09-22 |
| 1407804800 | Valerie June Malloy | Family Medicine | Offutt Afb, Erhling Berquist Clinic, Belluvue, NE 68113 | 2006-05-05 |
| 1457766909 | Robyn Thiede | Nurse Practitioner | 2501 Capehart Road, Family Medicine Residency Clinic, Ehrling Bergquist, Offutt Afb, NE 68113 | 2014-06-24 |
| Find all providers in zip 68113 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205940319 | Evan Paul Varkony | Family Medicine | 2501 Capehart Rd, Offutt A F B, NE 68113-1043 | 2006-08-18 |
| 1336133206 | Randall Howard Neal | Family Medicine | 2501 Capehart Rd, Ste 1m00, Offutt A F B, NE 68113-1043 | 2005-09-07 |
| 1811980261 | Wayne K Sumpter | Family Medicine | 2501 Capehart Rd, 55 Mdg, Offutt A F B, NE 68113-1043 | 2005-08-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740898907 | Physician Management Services of Nebraska, LLC | Family Medicine | 2222 S 16th St Ste 435, Lincoln, NE 68502-3793 | 2020-07-14 |
| 1891313706 | Me Urgent Care Nebraska, Inc | Family Medicine | 28800 Ida Cir, Valley, NE 68064-8017 | 2020-07-07 |
| 1356968408 | Joanna Sarah Jacob | Family Medicine | 3601 Jones St Apt 350, Omaha, NE 68105-1526 | 2020-07-05 |
| 1255958443 | Sreelakshmi Surendran Pillai | Family Medicine | 7710 Mercy Road, Suite 202-cu, Department of Family Mediicine, Omaha, NE 68124-2353 | 2020-07-03 |
| 1891312443 | Stefany Malanka | Family Medicine | 7710 Mercy Rd, Suite 202, Cu Department of Family Medicine, Omaha, NE 68124 | 2020-06-30 |
| 1831714062 | Allison Alise Bird | Family Medicine | Family Practice 983075 Nebraska Medical Center, Omaha, NE 68198-3075 | 2020-06-12 |
| 1508486416 | Bluestem Health | Family Medicine | 1500 S 48th St Ste 412, Lincoln, NE 68506-1278 | 2020-04-21 |
| 1285267526 | Banyan Medical Systems | Family Medicine | 8656 F St, Plaza F, Omaha, NE 68127-1639 | 2020-02-14 |
| 1669021796 | Melissa Prickett | Family Medicine | 14000 Hospital Road, Boys Town, NE 68010 | 2019-09-11 |
| 1144888579 | Lexington Regional Health Center | Family Medicine | 1101 Buffalo Bnd Ste A, Lexington, NE 68850-1528 | 2019-05-31 |
| Find all providers with the same taxonomy | ||||
| City | OFFUTT A F B |
| Zip Code | 68113 |
Please comment or provide details below to improve the information on ROGER TIMOTHY 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.