BOYOUNG PARK (NPI# 1982119392) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1982119392 |
| Entity Type | Individual |
| Full Name | BOYOUNG PARK |
| Practice Address |
4355 S National Ave Apt 905 Springfield MO 65810 |
| Mailing Address |
4355 S National Ave Apt 905 Springfield MO 65810-2655 |
| Practice Telephone | 4022139605 |
| Mailing Telephone | 4022139605 |
| Enumeration Date | 2017-12-07 |
| Last Update Date | 2018-07-27 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
4355 S NATIONAL AVE APT 905 |
| City | SPRINGFIELD |
| State | MO |
| Zip Code | 65810 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508373838 | Sunterra Springfield Oc, LLC | Skilled Nursing Facility | 4935 S National Ave, Springfield, MO 65810 | 2018-01-09 |
| 1578086310 | Missouri Telerad LLC | Radiology | 5117 South Neffleton Avenue, Springfiled, MO 65810 | 2017-07-24 |
| 1245597285 | Intrepid of Missouri, Inc. | Hospice Care, Community Based | 4305 S. National Ave., Springfield, MO 65810 | 2012-04-16 |
| 1700199668 | Telerad of Mo Account Management, LLC | Radiology | 5117 S. Neffleton Ave, Springfield, MO 65810 | 2010-07-21 |
| 1427286251 | Sam's Club Optical | Eyewear Supplier (Equipment, not the service) | 745 W El Camino Alto Drive, Springfield (s), MO 65810 | 2009-07-01 |
| 1033344304 | Teresa Mary Kaelin | Occupational Therapist | 3291 W. Ridge Run, Springfield, MO 65810 | 2009-05-15 |
| 1538366448 | Rani K Nair | Internal Medicine | 3231 S National Mercy Endocrineology, Ste 440, Springfield, MO 65810 | 2007-07-03 |
| 1467672519 | Missouri Dental Professionals, Richard Straus, Dmd, PC | Dentist | 4955 S. National Ave., Unit A, Springfield, MO 65810 | 2007-04-30 |
| 1336161983 | Leo Allan Tokarczyk | Dentist | 4777 S National Ave, Springfield, MO 65810 | 2006-07-24 |
| 1669433629 | Quail Creek Skilled Nursing, LLC | Skilled Nursing Facility | 1514 West Lark, Springfield, MO 65810 | 2006-03-30 |
| Find all providers in zip 65810 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538773361 | Aarika Danielle Gardner | Student in an Organized Health Care Education/Training Program | 560 W Bryant Apt D207, Springfield, MO 65810-8329 | 2020-08-31 |
| 1134743073 | Jared Saylor | Student in an Organized Health Care Education/Training Program | 901 S National Ave, Prof 160, Springfield, MO 65897 | 2020-06-06 |
| 1659995694 | Erin Bowler | Student in an Organized Health Care Education/Training Program | 51 Ingersoll Grv, Springfield, MA 01109-4010 | 2020-06-05 |
| 1063035483 | Mary Anne Iellamo | Student in an Organized Health Care Education/Training Program | 3400 Main St Fl 2, Springfield, MA 01199-1003 | 2020-05-20 |
| 1760005359 | Hannah Elizabeth Schumann | Student in an Organized Health Care Education/Training Program | 1621 E Lark St, Springfield, MO 65804-4351 | 2020-05-18 |
| 1962024109 | Brittany Nicole Campbell | Student in an Organized Health Care Education/Training Program | 2266 Boysenberry Ln Apt 4, Springfield, IL 62711-5414 | 2020-05-11 |
| 1518587286 | Emily Lyn Street | Student in an Organized Health Care Education/Training Program | 38 Country Pl, Springfield, IL 62703-5310 | 2020-04-22 |
| 1730709411 | Mary Kathleen Simon | Student in an Organized Health Care Education/Training Program | 1820 S Wiggins Ave, Springfield, IL 62704-3335 | 2020-04-22 |
| 1225658131 | Sarah Colby Mchugh | Student in an Organized Health Care Education/Training Program | 759 Chestnut St # S5427, Springfield, MA 01199-0001 | 2020-04-21 |
| 1346879889 | Ashly Seby | Student in an Organized Health Care Education/Training Program | 86 Redwood Rd Fl 3, Springfield, NJ 07081-2426 | 2020-04-06 |
| Find all providers in SPRINGFIELD | ||||
| City | SPRINGFIELD |
| Zip Code | 65810 |
Please comment or provide details below to improve the information on BOYOUNG 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.