KWANG-SOO PARK (NPI# 1689635880) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1689635880 |
Entity Type | Individual |
Full Name | KWANG-SOO PARK |
Credential | MD |
Practice Address |
6915 Tutt Blvd Ste 110b Colorado Springs CO 80923 |
Mailing Address |
1065 Ne 125th St Ste 409 North Miami FL 33161-5834 |
Practice Telephone | 7194451292 |
Practice Fax Number | 7195916486 |
Mailing Telephone | 8888526672 |
Mailing Fax Number | 8777200502 |
Enumeration Date | 2006-03-29 |
Last Update Date | 2018-07-30 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
0060675 | CO | Allopathic & Osteopathic Physicians |
N | 2084P0805X |
Psychiatry & Neurology Specialization: Geriatric Psychiatry |
DR0060675 | CO | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
WV | 1840930000 | 05 | |
OH | 2334978 | 05 |
Street Address |
6915 TUTT BLVD STE 110B |
City | COLORADO SPRINGS |
State | CO |
Zip Code | 80923 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1366439770 | Michael Salvatore Dugo | Family Medicine | 6915 Tutt Blvd Ste 110b, Colorado Springs, CO 80923-3591 | 2005-09-30 |
1750908539 | Compass Colorado Healthcare Systems, Inc. | Counselor | 6915 Tutt Blvd Ste 110b, Colorado Springs, CO 80923-3591 | 2020-06-29 |
1285277038 | Michael Gordon Herriott | Psychiatry & Neurology | 6915 Tutt Blvd Ste 110b, Colorado Springs, CO 80923-3591 | 2019-10-24 |
1659928562 | Tina M Nance | Registered Nurse | 6915 Tutt Blvd Ste 110b, Colorado Springs, CO 80923-3591 | 2019-08-26 |
1194386714 | Victoria Mae Rachel Mikolajczyk | Social Worker | 6915 Tutt Blvd Ste 110b, Colorado Springs, CO 80923-3591 | 2019-06-25 |
1902322852 | Sheri Nielsen Rockwood | Nurse Practitioner | 6915 Tutt Blvd Ste 110b, Colorado Springs, CO 80923-3591 | 2017-08-22 |
1528580487 | Joelle Josephina Bailey | Registered Nurse | 6915 Tutt Blvd Ste 110b, Colorado Springs, CO 80923-3591 | 2017-07-12 |
1245698661 | Valerie Ann Kehl | Nurse Practitioner | 6915 Tutt Blvd Ste 110b, Colorado Springs, CO 80923-3591 | 2016-01-29 |
1316312267 | Jason Michael Seed | Nurse Practitioner | 6915 Tutt Blvd Ste 110b, Colorado Springs, CO 80923-3591 | 2015-12-03 |
1477923407 | Tzu Hui Lee | Registered Nurse | 6915 Tutt Blvd Ste 110b, Colorado Springs, CO 80923-3591 | 2015-10-02 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1356942171 | Colorado Otolaryngology Associates, LLC | Specialist | 6031 E. Woodmen Rd., Ste. 300, Colorado Springs, CO 80923 | 2020-11-06 |
1750993861 | Kara Pitou | Dietitian, Registered | 7064 Renegade Ridge Dr, Colorado Springs, CO 80923 | 2020-08-19 |
1366933632 | The Traveling Therapist, LLC | Social Worker | 6319 Sundance Kid Dr, Colorado Springs, CO 80923 | 2018-05-22 |
1669972246 | Stacy H Furukawa | Behavior Technician | 5719 Hawk Springs Dr, Colorado Springs, CO 80923 | 2018-02-20 |
1528573854 | Wal-mart Sores, Inc. | Durable Medical Equipment & Medical Supplies | 7825 Dublin Blvd, Colorado Springs, CO 80923 | 2017-12-08 |
1699148544 | Kristin Sekelsky | Nurse Practitioner | 6160 Tutt Blvd Ste 150, Colorado Springs, CO 80923 | 2015-11-01 |
1164826640 | Nancy Bakhtiar | Massage Therapist | 6160 Tutt Blve #102, Colorado Springs, CO 80923 | 2014-10-13 |
1558664326 | Helen Sobeck | Nurse Practitioner | 6001 E. Woodmen Road, Nicu St. Frances Medical Center, Colorado Springs, CO 80923 | 2010-12-16 |
1679891832 | Tristan Poe Lindberg | Pediatrics | 6001 E Woodmen Road, Colorado Springs, CO 80923 | 2010-05-12 |
1194058933 | Tiffany Ann Nelson | Physician Assistant | 6001 E. Woodmen Rd., St. Francis Medical Center - Nicu, Colorado Springs, CO 80923 | 2009-09-11 |
Find all providers in zip 80923 |
Taxonomy Code | 2084P0800X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Psychiatry & Neurology |
Specialization | Psychiatry |
A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems. |
Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1417181751 | Kevin N Batterbee D.o. LLC | Psychiatry & Neurology | 13255 Honey Run Way, Colorado Springs, CO 80921-2087 | 2009-05-14 |
1215196696 | Deane Shore Berson | Psychiatry & Neurology | 1424 North Hancock Avenue 3 West, Deane Shore Berson Md, Colorado Springs, CO 80903 | 2008-06-02 |
1043477649 | Rhonda Nicole Sims | Psychiatry & Neurology | 6915 Tutt Boulevard, Suite 110b, Colorado Springs, CO 80923-3591 | 2008-05-21 |
1699963280 | Kurt Peters | Psychiatry & Neurology | 90 S Cascade Ave Ste 810, Colorado Springs, CO 80903-1675 | 2007-10-09 |
1184750408 | Thomas P Kittelsen | Psychiatry & Neurology | 7680 Goddard St Ste 120, Colorado Springs, CO 80920-8233 | 2007-02-23 |
1831237098 | Ardis Capprice Martin | Psychiatry & Neurology | 4740 Flintridge Dr, Suite 214, Colorado Springs, CO 80918-4253 | 2007-02-01 |
1700938289 | Scott Helm Mcclure | Psychiatry & Neurology | 90 S Cascade Ave, Suite 810, Colorado Springs, CO 80903 | 2007-01-17 |
1497805188 | David Udell Caster | Psychiatry & Neurology | 219 E Saint Vrain St, Colorado Springs, CO 80903-1121 | 2007-01-12 |
1962566695 | Cynthia Pearl Rose | Psychiatry & Neurology | 90 South Cascade Ave, Colorado Springs, CO 80903-1675 | 2006-12-20 |
1144396847 | Roger D Pumphrey | Psychiatry & Neurology | 100 E Saint Vrain St, Ste 200, Colorado Springs, CO 80903-4940 | 2006-11-27 |
Find all providers in COLORADO SPRINGS |
City | COLORADO SPRINGS |
Zip Code | 80923 |
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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.