Carolyn Jean Park, MD

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

2018-00986 Issued in NC

Practice address

1237 Harding PL
Ste 3100
Charlotte, NC 28204

Phone

(704) 373-0212

NPI assigned

Mar 27, 2015

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Cardiovascular Disease (Cardiology)Also: Hospitalist

Education

Drexel University College of Medicine, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Catawba Valley Medical Group IncGroup PAC ID 6305007279, 133 clinicians

Wake Forest University Health SciencesGroup PAC ID 4486564952, 2,633 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• North Carolina Baptist Hospital Hospital, Winston-Salem, NC, CCN 340047
• Wilkes Regional Medical Center Hospital, North Wilkesboro, NC, CCN 340064
• Catawba Valley Medical Center Hospital, Hickory, NC, CCN 340143
• High Point Regional Health System Hospital, High Point, NC, CCN 340004
• Iredell Memorial Hospital Inc Hospital, Statesville, NC, CCN 340039

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: cpark918699@carolinashealthcaresystem.direct-ci.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Catawba Valley Medical Group, Inc

  • Family Medicine Physician
  • Catawba, NC
  • NPI 1790062362
  Medicare reassignment Care Compare group NPD
• Wake Forest University Health Sciences

  • Multi-Specialty Clinic/Center
  • Winston Salem, NC
  • NPI 1003803032
  Medicare reassignment Care Compare group NPD
• Carolinas Physicians Network Inc

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Charlotte, NC
  • NPI 1477878890

  Cardiovascular Disease

  Medicare reassignment NPD
• Novant Health Medical Group, LLC

  • Neurology with Special Qualifications in Child Neurology Physician
  • Charlotte, NC
  • NPI 1366409492
  Medicare reassignment NPD
• Carolinas Physicians Network Inc

  • Endocrinology, Diabetes & Metabolism Physician
  • Charlotte, NC
  • NPI 1437038544
  NPD
• Carolinas Physicians Network Inc

  • Cardiovascular Disease Physician
  • Concord, NC
  • NPI 1710290564
  NPD
• Catawba Valley Medical Group Inc

  • Ambulatory Surgical Clinic/Center
  • Hickory, NC
  • NPI 1659267359
  NPD
• Catawba Valley Medical Group, Inc

  • Cardiovascular Disease Physician
  • Conover, NC
  • NPI 1750659488
  NPD
• Novant Health Medical Group, LLC

  • Hospitalist Physician
  • Winston Salem, NC
  • NPI 1073863221

  Internal Medicine

  NPD
• Novant Health Medical Group, LLC

  • Obstetrics & Gynecology Physician
  • Matthews, NC
  • NPI 1386506137
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Catawba Valley Medical Center

  • General Acute Care Hospital
  • Hickory, NC
  • NPI 1164495255
  Care Compare affiliation
• High Point Regional Health

  • General Acute Care Hospital
  • High Point, NC
  • NPI 1396746228
  Care Compare affiliation
• Iredell Memorial Hospital, Incorporated

  • General Acute Care Hospital
  • Statesville, NC
  • NPI 1417944224
  Care Compare affiliation
• North Carolina Baptist Hospital

  • Psychiatric Hospital Unit
  • Winston Salem, NC
  • NPI 1063480531
  Care Compare affiliation
• North Carolina Baptist Hospital

  • Rehabilitation Hospital Unit
  • Winston Salem, NC
  • NPI 1114995677
  Care Compare affiliation
• North Carolina Baptist Hospital

  • General Acute Care Hospital
  • Winston Salem, NC
  • NPI 1144211301
  Care Compare affiliation
• North Carolina Baptist Hospital

  • Clinical Medical Laboratory
  • Winston Salem, NC
  • NPI 1609162098

  Hospital

  Care Compare affiliation
• North Carolina Baptist Hospital

  • Pediatric Adolescent Medicine Physician
  • Winston Salem, NC
  • NPI 1912179219

  Hospital

  Care Compare affiliation
• WRMC Hospital Operating Corporation

  • General Acute Care Hospital
  • North Wilkesboro, NC
  • NPI 1881614071
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1427414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721174400000",
    "number": "1174917017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19305",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282199305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1237 HARDING PL",
            "address_2": "STE 3100",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "28204",
            "telephone_number": "704-373-0212"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10660 Park Rd",
            "address_2": "Ste 3400",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282108413",
            "country_code": "US",
            "telephone_number": "704-667-1540",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 Medical Park Dr",
            "address_2": "Ste 210",
            "address_purpose": "LOCATION",
            "city": "Concord",
            "state": "NC",
            "postal_code": "280252948",
            "country_code": "US",
            "telephone_number": "704-403-6100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10650 Park Rd",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282108538",
            "country_code": "US",
            "telephone_number": "704-667-3840",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1237 Harding Pl",
            "address_2": "Ste 4200",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "28204",
            "country_code": "US",
            "telephone_number": "704-373-0212",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PARK",
        "first_name": "CAROLYN",
        "middle_name": "JEAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-27",
        "last_updated": "2024-07-17",
        "certification_date": "2022-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "2018-00986",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NC",
            "license": "2018-00986",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cpark918699@CarolinasHealthcareSystem.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "Atrium Health",
            "address_1": "1237 Harding Pl",
            "address_2": "Ste 3100",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282042826",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "ABILITY Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "100 N 6th St Ste 900A",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554031516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Parisi Chiropractic PLLC
• Joseph Anthony Parisi, PH.D.
• Park Cedar Dentistry Partnership
• Park Road Health and Wellness Inc
• Park Village Rehab and Health, Inc.
• Ellen Park, BCBA, LBA
• Esther Jane Park, PHARM.D.
• Jenny Park
• Ji Hee Park, PHARMD
• Timothy Park, M.D.

• Cardiovascular Disease Physician in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Cardiovascular Disease Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.