SONGKI PARK (NPI# 1184173296) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184173296 |
| Entity Type | Individual |
| Full Name | SONGKI PARK |
| Credential | NP |
| Practice Address |
8500 Executive Park Ave Ste 202 Fairfax VA 22031-2253 |
| Practice Telephone | 7038527020 |
| Mailing Telephone | 7038527020 |
| Enumeration Date | 2016-09-30 |
| Last Update Date | 2016-09-30 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
0024174042 | VA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
8500 EXECUTIVE PARK AVE STE 202 |
| City | FAIRFAX |
| State | VA |
| Zip Code | 22031-2253 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588007538 | Sonia Jacqueline Trundy | Social Worker | 8500 Executive Park Ave Ste 202, Fairfax, VA 22031-2253 | 2013-04-09 |
| 1801497615 | Jenna Kelley | Counselor | 8500 Executive Park Ave Ste 202, Fairfax, VA 22031-2253 | 2020-11-06 |
| 1740640671 | Elizabeth Bailey | Counselor | 8500 Executive Park Ave Ste 202, Fairfax, VA 22031-2253 | 2016-03-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902414105 | Su Jung Kang | Dentist | 9661-c Main Street, Fairfax, VA 22031 | 2020-07-14 |
| 1346896347 | Fuling Guo | Acupuncturist | 3013 James St, Fairfax, VA 22031 | 2019-08-15 |
| 1902458797 | Kayla Callister | Psychologist | 2270 Willow Oaks Corporate Drive, Fairfax, VA 22031 | 2019-07-11 |
| 1790349801 | Fairfax Dental Esthetics | Dentist | 9621 Fairfax Blvd., Fairfax, VA 22031 | 2019-04-24 |
| 1417427675 | Kathryn Yen Ho | Speech-Language Pathologist | 8270 Willow Oaks Corporate Drive Suite 2127, Falls Church, VA 22031 | 2018-11-30 |
| 1932681376 | Joanne Towers | Physician Assistant | 3025 Hamaker Court Suite 300, Fairfax, VA 22031 | 2018-09-01 |
| 1790262020 | S Renee Dennis | Nurse Practitioner | 8316 Arlington Blvd Ste 500, Fairfax, VA 22031 | 2018-07-19 |
| 1013493451 | Elizabeth Joan Dwyer | Physician Assistant | 3023 Hamaker Ct., Suite 500, Fairfax, VA 22031 | 2018-07-18 |
| 1316432669 | Delta Pharm LLC | Pharmacy | 8316 Arlington Blvd Ste 100, Fairfax, VA 22031 | 2018-06-28 |
| 1629567656 | Laura Breeden | Acupuncturist | 3846 Lyndhurst Dr Apt 301, Fairfax, Va, VA 22031 | 2018-05-04 |
| Find all providers in zip 22031 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548876618 | Jamie Kim | Nurse Practitioner | 3554 Chain Bridge Rd Ste 200, Fairfax, VA 22030-2709 | 2020-09-23 |
| 1871139295 | Patricia Moyer Gilliam | Nurse Practitioner | 3805 Skyview Ln, Fairfax, VA 22031-3101 | 2019-11-20 |
| 1073003398 | Umu Coomber Benjamin | Nurse Practitioner | 3930 Pender Dr Ste 300, Fairfax, VA 22030-0986 | 2018-05-11 |
| 1992209993 | Natalia F Brigham | Nurse Practitioner | 8221 Willow Oaks Corporate Dr # 4-425, Fairfax, VA 22031-4512 | 2018-03-23 |
| 1376671032 | Shawan Helena Carr | Nurse Practitioner | 8221 Willow Oaks Corporate Dr Ste 4-420, Fairfax, VA 22031-4512 | 2007-03-02 |
| 1396261368 | Claire Milliken | Nurse Practitioner | 8221 Willow Oaks Corporate Dr Ste 4-425, Fairfax, VA 22031-4512 | 2017-08-21 |
| 1033592746 | Angela Susan Amas | Nurse Practitioner | 8221 Willow Oaks Corporate Dr, Fairfax, VA 22031-4512 | 2015-06-30 |
| 1710272083 | Suzanne Cox | Nurse Practitioner | 3930 Pender Dr Ste 350, Fairfax, VA 22030-0989 | 2011-06-15 |
| 1093766214 | Lora E Peppard | Nurse Practitioner | 4400 University Dr, George Mason University, Fairfax, VA 22030-4422 | 2006-05-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578160875 | Tricia Daigle Northington | Nurse Practitioner | 20213 Eagle Cove Ct, South Chesterfield, VA 23803-1097 | 2020-10-08 |
| 1114524543 | Alliance Mental Health LLC | Nurse Practitioner | 7400 Beaufont Springs Drive Pmb#2867, Suite 300, Richmond, VA 23225 | 2020-10-08 |
| 1699372060 | Shari Chism Medley | Nurse Practitioner | 1088 Bagwell Dr, Scottsburg, VA 24589-2709 | 2020-10-07 |
| 1225635683 | Kevina Boone | Nurse Practitioner | 5360 Discovery Park Blvd Ste 201, Williamsburg, VA 23188-2860 | 2020-10-07 |
| 1134734957 | Ai H Garner | Nurse Practitioner | 7400 Beaufont Springs Drive Pmb# 2867, Suite 300, Richmond, VA 23225 | 2020-09-09 |
| 1679185573 | Shaping Your Future Psychiatry | Nurse Practitioner | 1534 Bateau Lndg, Chesapeake, VA 23321-6603 | 2020-08-20 |
| 1235749714 | Germaine Kelley-pope | Nurse Practitioner | 622 Westover Hills Blvd, Richmond, VA 23225-4521 | 2020-08-09 |
| 1164031779 | Georgina Rose Chidaushe | Nurse Practitioner | 46760 Vermont Maple Ter, Sterling, VA 20164-2234 | 2020-07-29 |
| 1689292575 | Harpreet Kang | Nurse Practitioner | 2925 Calcutt Dr, Midlothian, VA 23113-2682 | 2020-07-08 |
| 1558989475 | Happy Minds LLC | Nurse Practitioner | 1206 Carter Braxton Ln, Williamsburg, VA 23188-7654 | 2020-07-07 |
| Find all providers with the same taxonomy | ||||
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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.