THOMAS PARK M.D. PC (NPI# 1881904605) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881904605 |
| Entity Type | Organization |
| Organization Name | THOMAS PARK M.D. PC |
| Practice Address |
23077 Greenfield Rd Suite 257 Southfield MI 48075-3709 |
| Practice Telephone | 2485520044 |
| Practice Fax Number | 2484237777 |
| Mailing Telephone | 2485520044 |
| Mailing Fax Number | 2484237777 |
| Enumeration Date | 2010-10-14 |
| Last Update Date | 2010-10-14 |
| Authorized Official Name | DR. THOMAS T PARK (PRESIDENT) |
| Authorized Official Telephone | 2485520044 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 305R00000X | Preferred Provider Organization | 4301040933 | MI | Managed Care Organizations |
| Street Address |
23077 GREENFIELD RD SUITE 257 |
| City | SOUTHFIELD |
| State | MI |
| Zip Code | 48075-3709 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326036849 | Thomas M Flake Jr. | Surgery | 23077 Greenfield Rd, Suite 445, Southfield, MI 48075-3709 | 2005-10-10 |
| 1366976375 | Legarius | Internal Medicine | 23077 Greenfield Rd, Ste156, Southfield, MI 48075-3709 | 2017-04-17 |
| 1972954865 | Caitlyn Crawford | Nurse Anesthetist, Certified Registered | 23077 Greenfield Rd, Southfield, MI 48075-3709 | 2016-06-22 |
| 1154776003 | Karen Alyse Waldrop | Counselor | 23077 Greenfield Rd, Suite 430, Southfield, MI 48075-3709 | 2016-04-28 |
| 1336510072 | Nephro-care Md Plc | Internal Medicine | 23077 Greenfield Rd, Suite 479, Southfield, MI 48075-3709 | 2015-10-07 |
| 1063880359 | Gasper Novara | Social Worker | 23077 Greenfield Rd, #430, Southfield, MI 48075-3709 | 2015-09-03 |
| 1235513623 | Greenfield Medical Orthopedic Pllc | Clinic/Center | 23077 Greenfield Rd, Suite 159, Southfield, MI 48075-3709 | 2015-07-15 |
| 1649651332 | Comprehensive Clinical Neurology | Specialist | 23077 Greenfield Rd, 222, Southfield, MI 48075-3709 | 2015-06-18 |
| 1548640766 | Pilltalk Pharmacy | Pharmacy | 23077 Greenfield Rd, 220, Southfield, MI 48075-3709 | 2015-06-03 |
| 1679987424 | Infectious Diseases Consultants of Detroit PC | Internal Medicine | 23077 Greenfield Rd, Suite 479, Southfield, MI 48075-3709 | 2014-06-19 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851900054 | K&b Medical Wigs, LLC | Durable Medical Equipment & Medical Supplies | 16250 Northland Dr. Ste 221, Southfield, MI 48075 | 2020-07-24 |
| 1790300390 | Julian Jeberaeel | Radiology | 2250 Providence, Southfield, MI 48075 | 2020-06-10 |
| 1265056410 | Husein Yusuf Husein | Podiatrist | Ascension Providence Hospital Southfield Campus, 16001 W. Nine Mile Rd. Depaul 2nd Floor, Southfield, Mi, MI 48075 | 2020-06-03 |
| 1952945420 | Paris Straughter | Nurse Practitioner | 18438 Onyx St, Southfield, MI 48075 | 2019-10-29 |
| 1811467657 | Medicine Man Medical, Pllc | Physical Medicine & Rehabilitation | 25130 Southfield Road, Suite #210, Southfield, MI 48075 | 2018-12-04 |
| 1447725528 | Rommel Ramos Perez | Physical Therapist | 26017 Greenfield Rd., Southfield, MI 48075 | 2018-10-04 |
| 1073009627 | Jacqueline Venora Goodgame | Licensed Practical Nurse | 4000 Town Ctr, Southfield, MI 48075 | 2018-07-06 |
| 1043712532 | Hollie Marie Maltese | Physical Therapy Assistant | 22255 Greenfiled 118, Southfield, MI 48075 | 2018-03-01 |
| 1932601481 | Katie Marie Mccormack | Occupational Therapist | 16001 West Nine Mile Rd., Southfield, MI 48075 | 2018-03-01 |
| 1801304241 | Absolute Hc LLC | Physical Therapist | 23461 Greenfield Rd Ste 200b, Southfield, MI 48075 | 2018-01-19 |
| Find all providers in zip 48075 | ||||
| Taxonomy Code | 305R00000X |
| Grouping | Managed Care Organizations |
| Classification | Preferred Provider Organization |
| A group of physicians and/or hospitals who contract with an employer to provide services to their employees. In a PPO, the patient may got to the physician of his/her choice, even if that physician does not participate in the PPO, but the patient receives care at a lower benefit level. |
| Notes: Source: "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/ October 1995, p. 62 |
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| 1376094268 | Therahealth Physio Therapy | Preferred Provider Organization | 20755 Greenfield Rd, Suite 602, Southfield, MI 48075-5403 | 2016-10-17 |
| 1063503910 | Medical Services of Detroit | Preferred Provider Organization | 24261 Greenfield Rd, Southfield, MI 48075-3117 | 2006-09-27 |
| 1154386563 | Hamtramck Physical Theraphy and Rehab Services, Inc. | Preferred Provider Organization | 20755 Greenfield Rd, Suite 803, Southfield, MI 48075-5403 | 2006-04-19 |
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| 1154777183 | Desiree Santiago | Preferred Provider Organization | 517 Graten St, Birmingham, MI 48009-6519 | 2016-05-09 |
| 1881062941 | Ford Dental Group | Preferred Provider Organization | 5601 Schaefer Rd Ste 101, Dearborn, MI 48126-4713 | 2015-09-07 |
| 1205230257 | Maria's Tender Loving Home Care | Preferred Provider Organization | 7233 Voerner Ave, Center Line, MI 48015-1810 | 2014-10-20 |
| Find all providers with the same taxonomy | ||||
| City | SOUTHFIELD |
| Zip Code | 48075 |
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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.