DR. BRIAN B PARK (NPI# 1891778064) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891778064 |
| Entity Type | Individual |
| Full Name | DR. BRIAN B PARK |
| Credential | DC |
| Practice Address |
4200 Edmondson Ave Suite 101 Baltimore MD 21229-1612 |
| Mailing Address |
9601 Pulaski Park Dr Suite 416 Baltimore MD 21220-1409 |
| Practice Telephone | 4109470300 |
| Practice Fax Number | 4109470328 |
| Mailing Telephone | 4109335678 |
| Mailing Fax Number | 4109331823 |
| Enumeration Date | 2005-11-22 |
| Last Update Date | 2015-07-01 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | S01759 | MD | Chiropractic Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MD | CAREFIRST | 685841 | 01 |
| MD | CAQH | 794476 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407333990 | Brian Park | Dentist | 5607 Uvalde Rd # G, Houston, TX 77049-4523 | 2018-07-26 |
| 1811014467 | Brian Keith Park | Home Health Aide | 477 White Pond Dr, Apt 421, Akron, OH 44320-1121 | 2007-03-26 |
| 1215027008 | Brian Park | Radiology | Dilorezno Tricare Health Clinic, Federal Building 2, Rm 1345, Washington, DC 20370-0001 | 2006-10-13 |
| 1467011775 | Brian Park | Student in an Organized Health Care Education/Training Program | 4610 X St, Sacramento, CA 95817-2200 | 2019-06-10 |
| 1598225070 | Brian Sooman Park | Student in an Organized Health Care Education/Training Program | 757 Westwood Plz, Los Angeles, CA 90095-6082 | 2019-03-21 |
| 1417451170 | Brian H Park | Student in an Organized Health Care Education/Training Program | 75 Francis St, Boston, MA 02115-6110 | 2018-03-19 |
| 1144757162 | Brian Park | Neurological Surgery | 200 Hawkins Dr Dept Of, Iowa City, IA 52242-1009 | 2017-05-22 |
| 1942737697 | Brian Park | Student in an Organized Health Care Education/Training Program | 833 Chestnut Street, Suite 220, Philadelphia, PA 19107-4405 | 2017-05-12 |
| 1710418744 | Brian Lim Park | Student in an Organized Health Care Education/Training Program | 1 Gustave L Levy Pl, New York, NY 10029 | 2017-03-22 |
| 1497203947 | Brian Park | Dentist | 11727 Whittier Blvd, Whittier, CA 90601-3939 | 2016-09-13 |
| Street Address |
4200 EDMONDSON AVE SUITE 101 |
| City | BALTIMORE |
| State | MD |
| Zip Code | 21229-1612 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629076443 | Helen V Boro | Chiropractor | 4200 Edmondson Ave, Baltimore, MD 21229-1612 | 2005-07-14 |
| 1215538434 | Delroy White Jr. | Social Worker | 4200 Edmondson Ave, Baltimore, MD 21229-1612 | 2020-11-04 |
| 1205484334 | Candice Hendrix | Social Worker | 4200 Edmondson Ave, Baltimore, MD 21229-1612 | 2019-09-02 |
| 1144889569 | Transform A Nation Inc | Community/Behavioral Health | 4200 Edmondson Ave, Baltimore, MD 21229-1612 | 2019-06-10 |
| 1053734566 | Pamela Harvey | Counselor | 4200 Edmondson Ave, Ste 200a, Baltimore, MD 21229-1612 | 2014-02-04 |
| 1154753242 | Ms-hc, LLC | Non-Pharmacy Dispensing Site | 4200 Edmondson Ave, Suite 101, Baltimore, MD 21229-1612 | 2013-07-31 |
| 1437592938 | Boundless Innovations for Holistc Living | Community/Behavioral Health | 4200 Edmondson Ave, Baltimore, MD 21229-1612 | 2013-04-15 |
| 1235481292 | Mary Prendergast | Counselor | 4200 Edmondson Ave, Baltimore, MD 21229-1612 | 2012-10-15 |
| 1376841320 | Roxanne L Talbott | Counselor | 4200 Edmondson Ave, Suite 200a, Baltimore, MD 21229-1612 | 2011-02-28 |
| 1053639955 | Billy D. Davis | Dentist | 4200 Edmondson Ave, Suite 201, Baltimore, MD 21229 | 2010-05-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265068373 | Bodyworks Medical | Clinic/Center | St. Agnes Medical Center, 3455 Wilkens Ave Suite 100, Baltimore, MD 21229 | 2020-03-20 |
| 1750932430 | Amanda Felix | Nurse Practitioner | 5411 Old Frederick Road, Catonsville, MD 21229 | 2019-09-24 |
| 1497317853 | Wakeelat A Adeoye | Nurse Practitioner | 5411 0ld Fredrick Rd, Suite 7, Baltimore, MD 21229 | 2019-07-05 |
| 1598328080 | Oprah Cherelle Keyes | Social Worker | 4511 Birchwood Drive, Baltimore, MD 21229 | 2019-04-19 |
| 1477051779 | Shahin Vohara | Dentist | Dental Dreams, 4510 Edmondson Avenue, Edmondson Village Shopping Center, Baltimore, MD 21229 | 2018-02-01 |
| 1386179299 | Sharon Mccollough | Counselor | 3219 Phelps Lane, First Floor, Baltimore, MD 21229 | 2017-04-28 |
| 1184175697 | Yekeen Odewale | Registered Nurse | 5411 Old Frederick Rd Ste 7, Baltimore, MD 21229 | 2016-10-19 |
| 1942608070 | Charity Ashe | Social Worker | 4024 Colborne Rd, Baltimore, MD 21229 | 2014-12-05 |
| 1376947127 | Sumanya Venkat Rao | Dentist | 4510 Edmondson Ave, Baltimore, MD 21229 | 2014-10-21 |
| 1497091573 | Anita Phillips | Social Worker | 5110 Frederick Avenue, Baltimore, MD 21229 | 2012-12-18 |
| Find all providers in zip 21229 | ||||
| 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 |
|---|---|---|---|---|
| 1992314090 | 360 Rehabilitation & Chiropractic LLC | Chiropractor | 2010 Clipper Park Rd Ste 117, Baltimore, MD 21211-1439 | 2020-07-24 |
| 1639798259 | Atlantic Reliable Care, LLC | Chiropractor | 2401 Liberty Heights Ave Ste 1020, Baltimore, MD 21215-8019 | 2020-04-14 |
| 1528608379 | Baltimore Integrative Health LLC | Chiropractor | 1800 N Charles St Ste 810, Baltimore, MD 21201-5987 | 2020-01-09 |
| 1326609827 | Mandip Kaur | Chiropractor | 2001 Eastern Ave Ste 1, Baltimore, MD 21231-3061 | 2019-06-25 |
| 1710458658 | Mid-atlantic Spinal Rehab & Chiropractic | Chiropractor | 6810 Park Heights Ave Ste C4, Baltimore, MD 21215-1662 | 2018-12-17 |
| 1003381377 | Andrea Lynnette Samuels | Chiropractor | 5411 Old Frederick Rd Ste 2, Baltimore, MD 21229-2126 | 2018-10-12 |
| 1275028706 | Gabriel A Martinez Md Pa | Chiropractor | 9106 Philadelphia Rd Ste 306, Baltimore, MD 21237-4343 | 2018-06-27 |
| 1366931214 | Randy Hallman, P.C. | Chiropractor | 2700 Fait Ave, Baltimore, MD 21224-3834 | 2018-05-07 |
| 1750895967 | Kashi Chesapeake Chiropractic and Spinal Rehab, PC | Chiropractor | 1103 N Point Blvd Ste 404, Baltimore, MD 21224-3486 | 2017-11-27 |
| 1306358098 | Zachary Woods | Chiropractor | 2001 Eastern Avenue, 1st Floor, Baltimore, MD 21231 | 2017-11-02 |
| Find all providers in BALTIMORE | ||||
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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.