Sora Park, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

95846 Issued in GA

Practice address

519 Memorial Dr SE Unit B10
Atlanta, GA 30312-2289

Phone

(470) 223-8983

NPI assigned

Apr 2, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1554163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692748800000",
    "number": "1376005090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 S. PERRY ST.",
            "address_2": "STE 206 #8276",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "30046",
            "telephone_number": "470-223-8983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "519 MEMORIAL DR SE UNIT B10",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303122289",
            "telephone_number": "470-223-8983"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "SORA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-02",
        "last_updated": "2023-08-23",
        "certification_date": "2023-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "GA",
            "license": "95846",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peter Ju Park, M.D.
• Romi Park, DMD
• Sam Ok Park, OTR/L
• Sarah Park, MD
• Soojeong Kim Park, MS, RD, CDE
• Sunita Park, MD
• Suyon Lee Park, DDS
• Tiffany Park
• Yaejin Park, MD
• Yeon Park, ACNP-BC

• Psychiatry Physician in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Psychiatry Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.