DR. INN T PARK (NPI# 1588713853) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588713853 |
| Entity Type | Individual |
| Full Name | DR. INN T PARK |
| Credential | M.D. |
| Practice Address |
2323 N Ash St Nevada MO 64772-1054 |
| Mailing Address |
Rr 6 Box 85 Nevada MO 64772-9773 |
| Practice Telephone | 4176677833 |
| Mailing Telephone | 4176673010 |
| Enumeration Date | 2007-01-09 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320900000X | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | R2A60 | MO | Residential Treatment Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306000120 | Inn Jee Park | Optometrist | 1 Highland Ave # 3b, Mass Optometric Associates, P.C., Malden, MA 02148-6603 | 2008-07-10 |
| Street Address |
2323 N ASH ST |
| City | NEVADA |
| State | MO |
| Zip Code | 64772-1054 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114971702 | State of Missouri | Psychiatry & Neurology | 2323 N Ash St, Nevada, MO 64772-1054 | 2006-05-19 |
| 1811137516 | State of Missouri | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 2323 N Ash St, Nevada, MO 64772-1054 | 2009-02-20 |
| 1376614701 | State of Missouri | Intermediate Care Facility, Mentally Retarded | 2323 N Ash St, Nevada, MO 64772-1054 | 2006-11-09 |
| 1013940469 | Lewis Shilane | Family Medicine | 2323 N Ash St, Nevada Habilitation Center, Nevada, MO 64772-1054 | 2006-07-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184116170 | Elizabeth Hoang | Dentist | 14054 Us-54, Nevada, MO 64772 | 2018-06-05 |
| 1376056424 | Chelsea Deines | Social Worker | 19940 S. 1481 Road, Nevada, MO 64772 | 2017-11-13 |
| 1558712422 | Ozark Tri County Healthcare Consortium | Dentist | 204 N Cedar, Nevada, MO 64772 | 2016-06-22 |
| 1144605312 | Nevada City Hospital | Clinic/Center | 627 S Ash St Ste B, Nevada, MO 64772 | 2015-07-29 |
| 1205233129 | Julie Ann Parker | Dental Hygienist | 204 North Cedar, Nevada, MO 64772 | 2014-11-20 |
| 1023432101 | Ashley Mckinney | Speech-Language Pathologist | 811 W Hickory, Nevada, MO 64772 | 2014-02-11 |
| 1477975183 | Krc 1505 Health Care Services LLC | Assisted Living Facility | 1505 East Ashland Street, Nevada, MO 64772 | 2014-01-15 |
| 1649520727 | Kathy J Hallam | Registered Nurse | 320 N Mac Boulevard, Nevada, MO 64772 | 2012-09-14 |
| 1396090916 | Emily Lane | Speech-Language Pathologist | 16927 S 1413 Rd, Nevada, MO 64772 | 2012-07-19 |
| 1427385517 | Nevada City Hospital | Clinic/Center | 345 S Barrett Ln., Nevada, MO 64772 | 2009-11-10 |
| Find all providers in zip 64772 | ||||
| Taxonomy Code | 320900000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities |
| A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528333085 | State of Missouri | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1000 N Colorado St, Nevada, MO 64772-1618 | 2012-03-16 |
| 1205951217 | Skills Unlimited, Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1428 W Walnut St, Nevada, MO 64772-1966 | 2007-03-20 |
| 1801852538 | Wilkinson Pharmacy, Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 105 S Oak, Nevada, MO 64772-3436 | 2006-04-21 |
| 1902284755 | Preferred Family Healthcare | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 429 E Walnut St, Nevada, MO 64772-2457 | 2015-05-13 |
| 1811137516 | State of Missouri | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 2323 N Ash St, Nevada, MO 64772-1054 | 2009-02-20 |
| 1346365343 | Skills Unlimited Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 2000 N Elm St, Nevada, MO 64772-1073 | 2007-03-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609475516 | Brandi Janelle Hickman | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 8706 Newton Ave Apt 4101, Kansas City, MO 64138-5461 | 2020-10-21 |
| 1154935112 | Overcomers Counseling Center Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 17101 East 203rd St, Peculiar, MO 64078 | 2020-09-06 |
| 1386265965 | Candace Palmer | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 2405 Bowe Ln, Jefferson City, MO 65109-9116 | 2020-05-05 |
| 1902426596 | Matt Ferguson | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 4480 Bradley Dr, Joplin, MO 64804-5503 | 2020-04-23 |
| 1689206211 | Insight Industry LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 2501 Ne Prairie Falcon Dr, Blue Springs, MO 64014-1958 | 2020-02-11 |
| 1598306904 | Hearo Technologies LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 405 N Jefferson Ave Ste 1063, Springfield, MO 65806-1110 | 2019-10-07 |
| 1437790219 | Darin Roark | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 2628 Se Kimbrough Ln, Lees Summit, MO 64063-1082 | 2019-10-03 |
| 1942851399 | Wyatt's Dream Center | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 205 State Highway Aa, Sikeston, MO 63801-5303 | 2019-09-26 |
| 1043871908 | Cura Personalis, (care for The Whole Person), LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 11650 Bobwhite Road, Carthage, MO 64836 | 2019-06-21 |
| 1043870181 | Rebuild Contracting LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1783 Possum Hollow Dr, Camdenton, MO 65020-6709 | 2019-06-20 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on DR. INN T 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.