Chan Kyu Park, D.C.
NPI 1639541485ActiveIndividual· Chiropractor· Johns Creek, GA
Chiropractor (D.C.) in Johns Creek, Georgia, trained at Life Chiropractic College (class of 2012). Enrolled in Medicare as practitioner - chiropractic.
Overview
| NPI | 1639541485 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | D.C. |
| Sole proprietor | No |
| NPI issued | Oct 20, 2015 |
| Last updated in NPPES | Jan 14, 2022 |
| Certified by provider | Jan 14, 2022 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Chiropractor Primary | 111N00000X | CHIR009022 | GA |
| Chiropractor, Rehabilitation | 111NR0400X | CHIR009022 | GA |
| Chiropractor, Sports Physician | 111NS0005X | CHIR009022 | GA |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Chiropractic (GA) |
|---|
Education and affiliations
| Medical school | Life Chiropractic College |
|---|---|
| Graduation year | 2012 |
| Medicare specialty | Chiropractic |
Industry payments (Open Payments)
None reported for 2025 or 2024.
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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All 32 chiropractors in Johns Creek · All chiropractors in Georgia