MR. RYAN PARK (NPI# 1760738728) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760738728 |
| Entity Type | Individual |
| Full Name | MR. RYAN PARK |
| Credential | NP |
| Practice Address |
360 E Montvue Dr. Ste 100 Meridian ID 83642 |
| Mailing Address |
1105 2nd St S Ste 100 Nampa ID 83651-3911 |
| Practice Telephone | 2088552900 |
| Practice Fax Number | 2088989877 |
| Mailing Telephone | 4808621677 |
| Mailing Fax Number | 4807187643 |
| Enumeration Date | 2012-07-27 |
| Last Update Date | 2018-04-26 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
NP-1200A | ID | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316477524 | Ryan Park | Dentist | Jared White Rd, Attn: Credentials, Tripler Amc, HI 96859-5000 | 2017-06-20 |
| 1033663596 | Ryan Park | Dentist | 605 Northwest Pkwy Ste 130, Azle, TX 76020-2946 | 2016-08-12 |
| 1073006771 | Ryan Park | Behavioral Analyst | 1171 Homestead Rd Ste 250, Santa Clara, CA 95050-5485 | 2018-06-07 |
| 1376033753 | Ryan J Park | Student in an Organized Health Care Education/Training Program | 75 Francis St, Boston, MA 02115-6110 | 2018-05-11 |
| 1144322363 | Ryan Scott Park | Orthopaedic Surgery | 317 N El Camino Real, Suite 405, Encinitas, CA 92024-2811 | 2006-09-01 |
| Street Address |
360 E MONTVUE DR. STE 100 |
| City | MERIDIAN |
| State | ID |
| Zip Code | 83642 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174145684 | Ikdo South Meridian LLC | Dentist | 3839 E Amity Rd, Meridian, ID 83642 | 2020-05-07 |
| 1073133328 | Prescription Pad LLC | Pharmacy | 885 S Vanguard Way, Meridian, ID 83642 | 2020-04-16 |
| 1609412683 | Meridian Advanced Psychiatry, LLC | Psychiatry & Neurology | 1672 S Woodsage Ave., Meridan, ID 83642 | 2019-11-25 |
| 1194378927 | Sergey Tsema | Occupational Therapist | 1259 E Pisa St, Meridian, ID 83642 | 2019-07-21 |
| 1003478629 | Chris R Jackson | Dentist | Isu Family Dentistry, 1311 E Central Dr, Meridian, ID 83642 | 2019-07-03 |
| 1285293118 | Morgan Family Medicine | Nurse Practitioner | 1660 S Woodsage Avenue, Meridian, ID 83642 | 2019-06-13 |
| 1033772793 | Nugen Healthcare, Pllc | Registered Nurse | 2177 S Spoonbill Ave, Meridian, ID 83642 | 2019-04-18 |
| 1811471790 | Courtney Crossland | Physician Assistant | 4949 S Hillsdale Ave., Meridian, ID 83642 | 2018-09-18 |
| 1841771938 | Katelyn Perry | Counselor | 2068 S. Eagle Rd., Meridian, ID 83642 | 2018-08-27 |
| 1114406204 | Gem Prep: Meridian LLC | Case Management | 2750 E.gala Ct., Meridian, ID 83642 | 2018-08-09 |
| Find all providers in zip 83642 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104427152 | Christopher Alan Anthony Nicholas | Nurse Practitioner | 2889 N Chancery Pl, Meridian, ID 83646-7407 | 2020-11-05 |
| 1659971380 | Lucy M Barnes | Nurse Practitioner | 2401 State Blvd, Meridian, MS 39307-5033 | 2020-10-30 |
| 1982202743 | Jayson Paul Smith | Nurse Practitioner | 1545 East Leighfield Dr., Meridian, ID 83646 | 2020-10-14 |
| 1649885534 | Auston Whitmer | Nurse Practitioner | 2203 E Ringneck St, Meridian, ID 83646-7410 | 2020-09-09 |
| 1407460157 | Kimberly N Lacap | Nurse Practitioner | 5961 Hwy 145, Meridian, MS 39301-9761 | 2020-09-01 |
| 1134733728 | Courtney S Dubose | Nurse Practitioner | 8252 Lizelia Rd, Meridian, MS 39305-8511 | 2020-09-01 |
| 1740890698 | Kimberly Parker | Nurse Practitioner | 4708 Hickory Hills Cir, Meridian, MS 39305-2440 | 2020-08-05 |
| 1396369138 | Tracy Ann Roberts | Nurse Practitioner | 3639 S Arno Ave, Meridian, ID 83642-1396 | 2020-06-06 |
| 1285293118 | Morgan Family Medicine | Nurse Practitioner | 1660 S Woodsage Avenue, Meridian, ID 83642 | 2019-06-13 |
| 1285293639 | Lindsey Sand | Nurse Practitioner | 2347 E Gala St # 150, Meridian, ID 83642-4881 | 2019-06-10 |
| Find all providers in MERIDIAN | ||||
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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.