Jongbae Jay Park, KMD, PHD, L.AC.
NPI 1194987792ActiveIndividual· Acupuncturist· Durham, NC
Acupuncturist (KMD, PHD, L.AC.) in Durham, North Carolina, licensed in NC, with an NPI issued in June 2008.
Overview
| NPI | 1194987792 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | KMD, PHD, L.AC. |
| Sole proprietor | Yes |
| NPI issued | Jun 26, 2008 |
| Last updated in NPPES | Oct 9, 2020 |
| Certified by provider | Oct 9, 2020 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Acupuncturist Primary | 171100000X | 490 | NC |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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