CHAN KYU PARK (NPI# 1639541485) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639541485 |
| Entity Type | Individual |
| Full Name | CHAN KYU PARK |
| Credential | D.C. |
| Practice Address |
6630 Mcginnis Ferry Rd Suite B Johns Creek GA 30097-2164 |
| Mailing Address |
3455 Dalwood Dr Suwanee GA 30024-6645 |
| Practice Telephone | 6784730552 |
| Practice Fax Number | 6784730656 |
| Mailing Telephone | 6784730552 |
| Mailing Fax Number | 6784730656 |
| Enumeration Date | 2015-10-20 |
| Last Update Date | 2015-10-20 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | CHIR009022 | GA | Chiropractic Providers |
| N | 111NS0005X |
Chiropractor Specialization: Sports Physician |
CHIR009022 | GA | Chiropractic Providers |
| N | 111NR0400X |
Chiropractor Specialization: Rehabilitation |
CHIR009022 | GA | Chiropractic Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | GROUP NPI | 1588908685 | 01 |
| Street Address |
6630 MCGINNIS FERRY RD SUITE B |
| City | JOHNS CREEK |
| State | GA |
| Zip Code | 30097-2164 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033150503 | Northwest Diagnostic Imaging, Inc | Radiology | 6630 Mcginnis Ferry Rd, Johns Creek, GA 30097-1542 | 2006-06-08 |
| 1588908685 | Better Spine Better Health, LLC | Chiropractor | 6630 Mcginnis Ferry Rd, Suite B, Johns Creek, GA 30097-1542 | 2012-11-15 |
| 1740450071 | Comprehensive Foot & Ankle, LLC | Podiatrist | 6630 Mcginnis Ferry Rd, Suite B, Johns Creek, GA 30097-1542 | 2008-03-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659986057 | Herman Medical Solutions, LLC | Internal Medicine | 10700 Medlock Bridge Road, Suite 207, Duluth, GA 30097 | 2020-09-11 |
| 1649808619 | Kirsty Amber Ramirez | Behavior Technician | 218 Premiere Pkwy #500, Duluth, GA 30097 | 2020-03-27 |
| 1386277820 | Cristina Madalina Niculas | Pharmacist | Kroger Pharmacy 476, 6555 Sugarloaf Parkway, Duluth, GA 30097 | 2020-02-12 |
| 1619514924 | Opesdei Health Solutions | Home Health Aide | 6615 Abbotts Bridge Road, 6615 Abbotts Bridge Road Unit 1111, Johns Creek, GA 30097 | 2019-12-05 |
| 1700422979 | Ria Alexander | Nurse Practitioner | 6300 Hospital Parkway Ste 300, Johns Creek, GA 30097 | 2019-11-22 |
| 1043867765 | Mosesal Zakia White | Nurse Practitioner | 10680 Medlock Bridge Rd #102, Johns Creek, GA 30097 | 2019-08-19 |
| 1982187068 | Lighthouse Clinical Counseling, LLC | Counselor | 3883 Rogers Bridge Road, Suite 601, Duluth, GA 30097 | 2018-09-13 |
| 1376025643 | Faithe Beanne Kimsey | Counselor | 3883 Rogers Bridge Road Nw, Suite 601, Duluth, GA 30097 | 2018-09-04 |
| 1306330303 | Denise Jackson | Prosthetist | 11720 Medlock Bridge Rd Ste 155, Johns Creek, GA 30097 | 2018-06-21 |
| 1407363328 | Berkeley Van Dyke | Physical Therapist | 6335 Hospital Pkwy Ste 316, Johns Creek, GA 30097 | 2017-12-30 |
| Find all providers in zip 30097 | ||||
| Taxonomy Code | 111N00000X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548714702 | Klariss Cotto | Chiropractor | 6395 Mcginnis Ferry Rd, Suite 301, Johns Creek, GA 30005-3633 | 2016-08-05 |
| 1104379676 | Enhanced Wellness Chiropractic | Chiropractor | 6395 Mcginnis Ferry Rd Ste 301, Johns Creek, GA 30005-3673 | 2016-08-01 |
| 1770957144 | Mario Perazza | Chiropractor | 10360 Medlock Bridge Rd Ste J, Johns Creek, GA 30097-5927 | 2015-11-22 |
| 1538548730 | Kikwang Nam | Chiropractor | 10900 Medlock Bridge Rd Ste 202, Johns Creek, GA 30097-1505 | 2015-05-21 |
| 1720485246 | 100 Percent Chiropractic Atlanta Three LLC | Chiropractor | 11030 Bell Rd, Suite 230, Johns Creek, GA 30097-1978 | 2014-11-26 |
| 1902037799 | Shannon Beth Darrow | Chiropractor | 10475 Medlock Bridge Rd Ste 810, Johns Creek, GA 30097-4437 | 2009-07-28 |
| 1437297900 | Young-kyu Ryu | Chiropractor | 6290 Abbotts Bridge Rd Ste 204, Johns Creek, GA 30097-1750 | 2007-02-04 |
| 1316001985 | Troy Reed Fortin | Chiropractor | 6000 Medlock Bridge Pkwy, Suite C-300, Johns Creek, GA 30022-8172 | 2006-12-20 |
| 1811535206 | Michael Joseph Tonry | Chiropractor | 9950 Jones Bridge Rd Ste 600, Johns Creek, GA 30022-6576 | 2019-12-16 |
| 1497307706 | Jl Health Center LLC | Chiropractor | 6290 Abbotts Bridge Rd Ste 204, Johns Creek, GA 30097-1750 | 2019-07-16 |
| Find all providers in JOHNS CREEK | ||||
| City | JOHNS CREEK |
| Zip Code | 30097 |
Please comment or provide details below to improve the information on CHAN KYU 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.