GRACE PARK (NPI# 1407410004) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407410004 |
| Entity Type | Individual |
| Full Name | GRACE PARK |
| Credential | MD |
| Practice Address |
1215 Lee St Charlottesville VA 22908-0816 |
| Mailing Address |
1215 Lee St Box 800501 Charlottesville VA 22908-0816 |
| Practice Telephone | 4349245321 |
| Practice Fax Number | 4349823816 |
| Mailing Telephone | 4349245321 |
| Mailing Fax Number | 4349823816 |
| Enumeration Date | 2019-04-29 |
| Last Update Date | 2019-04-29 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679970859 | Grace Park | Chiropractor | 20627 Golden Springs Dr., 2-b, Diamond Bar, CA 91789 | 2014-12-03 |
| 1710261243 | Grace Eunhye Park | Pharmacist | 125-133 3rd Ave, New York, NY 10003-2543 | 2011-10-03 |
| 1164677464 | Grace Jiyoung Park | Family Medicine | 15446 S. Western Ave, Southern California Permanente Medical Group, Gardena, CA 90249 | 2008-12-01 |
| 1619147592 | Grace Lee Park | Family Medicine | 1109 S. Lincoln Ave., Mckinley Health Center, Urbana, IL 61801 | 2008-03-06 |
| 1033311634 | Grace S Park | Acupuncturist | 7122 Bon Villa Cir, La Palma, CA 90623-1167 | 2007-06-05 |
| 1871602722 | Grace Eunkyoung Park | Dentist | 1024 Sw Highland Dr, #a, Gresham, OR 97080-6353 | 2006-08-30 |
| 1770551954 | Grace E. Park | Pharmacist | 11655 Riverside Dr, North Hollywood, CA 91602-1021 | 2006-03-14 |
| 1639707573 | Grace Park | Student in an Organized Health Care Education/Training Program | 400 W Mineral King Ave, Visalia, CA 93291-6237 | 2020-03-27 |
| 1730739152 | Grace Hyeyoung Park | Pharmacist | 1625 N Campbell Ave, Tucson, AZ 85719-4330 | 2019-09-17 |
| 1275092249 | Grace Eun Park | Behavior Technician | 3230 E Imperial Hwy Ste 203, Brea, CA 92821-1706 | 2019-03-18 |
| Street Address |
1215 LEE ST |
| City | CHARLOTTESVILLE |
| State | VA |
| Zip Code | 22908-0816 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760486328 | Kirk W Tanner | Nurse Anesthetist, Certified Registered | 1215 Lee St, Charlottesville, VA 22908-0816 | 2005-06-10 |
| 1801493283 | Angela Jewell Strickler | Nurse Practitioner | 1215 Lee St, Charlottesville, VA 22908-0816 | 2020-10-08 |
| 1629675475 | Kimberlee M Mauck | Physician Assistant | 1215 Lee St, Charlottesville, VA 22908-0816 | 2020-10-05 |
| 1407463953 | Amy Johnston | Clinical Nurse Specialist | 1215 Lee St, Charlottesville, VA 22908-0816 | 2020-09-29 |
| 1194332882 | Mihwa Ahn | Nurse Practitioner | 1215 Lee St, Charlottesville, VA 22908-0816 | 2020-09-26 |
| 1346856721 | Farren Hume Dodson | Nurse Practitioner | 1215 Lee St, Charlottesville, VA 22908-0816 | 2020-09-21 |
| 1003422619 | Darlene Acero | Dietitian, Registered | 1215 Lee St, Charlottesville, VA 22908-0816 | 2020-09-18 |
| 1689289571 | Erin Harr | Nurse Practitioner | 1215 Lee St, Charlottesville, VA 22908-0816 | 2020-09-09 |
| 1518572460 | Juan Pablo Sardi Restrepo | Student in an Organized Health Care Education/Training Program | 1215 Lee St, Mail Stop 800212, Charlottesville, VA 22908-0816 | 2020-09-08 |
| 1366055956 | Erin Louise Tennyson | Nurse Practitioner | 1215 Lee St, Charlottesville, VA 22908-0816 | 2020-08-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568020410 | Alexis Evans | Physician Assistant | 1215 Lee St Nnicu, Charlottesville, VA 22908 | 2019-06-04 |
| 1649702317 | Ryan Aschenbrener | Student in an Organized Health Care Education/Training Program | 545 Ray C Hunt Drive Suite 2400, Charlottesville, VA 22908 | 2017-03-31 |
| 1215399241 | Katherine Gresham Belote | Student in an Organized Health Care Education/Training Program | 1221 Lee Street Uva Health System, Charlottesville, VA 22908 | 2016-03-29 |
| 1851776215 | Catherine Meller | Student in an Organized Health Care Education/Training Program | 1215 Lee St., Box 800713, Charlottesville, VA 22908 | 2015-07-28 |
| 1295112597 | Breanna Campbell | Internal Medicine | 1220 Lee St Ste 2401, Charlottesville, VA 22908 | 2015-05-06 |
| 1013255637 | Melinda Bowles-childress | Nurse Practitioner | 1 Hospital Dr Fl 1, Charlottesville, VA 22908 | 2013-01-17 |
| 1053521757 | Univeristy of Virginia Health System | General Acute Care Hospital | University of Virginia Health System, 1215 Lee Street, Chalrlottesville, VA 22908 | 2007-05-23 |
| 1730241282 | Imre Noth | Internal Medicine | 1221 Lee St Fl 2, Charlottesville, VA 22908 | 2006-12-14 |
| 1023185394 | Tamer Ghanem | Otolaryngology | Dept. Otolaryngology, University of Virginia, 1 Hospital Dr., 2nd Floor Oms Rm 2747, Charlottesville, VA 22908 | 2006-11-29 |
| 1366401242 | Lisa M Christianson | Obstetrics & Gynecology | Uva Elson Student Health Center, 400 Brandon Avenue, Charlottesville, VA 22908 | 2006-03-21 |
| Find all providers in zip 22908 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477160158 | Mohamed Zaghloul Bayoumy Aly Hussein | Student in an Organized Health Care Education/Training Program | 2145 Inglewood Dr Apt 315, Charlottesville, VA 22901-2790 | 2020-09-28 |
| 1952917809 | Randi Woodard | Student in an Organized Health Care Education/Training Program | 1013 Linden Ave Apt O, Charlottesville, VA 22902-9022 | 2020-09-16 |
| 1023628583 | Robert Anderson Buchanan | Student in an Organized Health Care Education/Training Program | 1215 Lee St # 800672, Charlottesville, VA 22908-0816 | 2020-08-08 |
| 1083224307 | Peter Zvarych Fraser-morris | Student in an Organized Health Care Education/Training Program | 1215 Lee St Box # 800672, Charlottesville, VA 22908-0816 | 2020-08-01 |
| 1063032449 | Juan Tomas Santiago | Student in an Organized Health Care Education/Training Program | 1215 Lee St Box #800699, Charlottesville, VA 22908-0816 | 2020-04-25 |
| 1043839913 | Alexandra Lilly Deal | Student in an Organized Health Care Education/Training Program | 1215 Lee Street Mail Stop 800376, Charlottesville, VA 22908-0816 | 2020-04-10 |
| 1154950467 | Lawal A Labaran | Student in an Organized Health Care Education/Training Program | 1215 Lee St Box # 801016, Charlottesville, VA 22908-0816 | 2020-04-07 |
| 1881222776 | Monica Mary Matsumoto | Student in an Organized Health Care Education/Training Program | 3302 Rosebud Ln, Charlottesville, VA 22903-9348 | 2020-03-28 |
| 1265060248 | Brittany Nicole Heck | Student in an Organized Health Care Education/Training Program | 630 Cabell Ave Apt E, Charlottesville, VA 22903-2032 | 2020-03-27 |
| 1720615719 | Olivia Kerebi Ondigi | Student in an Organized Health Care Education/Training Program | 1215 Lee Street Mailing Stop 800744, Charlottesville, VA 22908-0816 | 2020-03-27 |
| Find all providers in CHARLOTTESVILLE | ||||
| City | CHARLOTTESVILLE |
| Zip Code | 22908 |
Please comment or provide details below to improve the information on GRACE 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.