Individual provider Active NPI

Susan Park, M.D.

  • Pediatrics Physician
  • Arlington, VA
National Provider Identifier
1376605873
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
0101240558 Issued in VA
Practice address
200 N Glebe Rd
Suite 300
Arlington, VA 22203-3728
Phone
(703) 243-1300
Fax
(703) 243-1151
NPI assigned
Dec 14, 2006
Last updated
Sep 11, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 0101240558 VA
Pediatrics Physician 208000000X 0101240558 VA Primary

Addresses

Primary practice location

200 N Glebe Rd
Suite 300
Arlington, VA 22203-3728

Mailing address

200 N Glebe Rd
Suite 300
Arlington, VA 22203-3728
Phone (703) 243-1300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0101240558VAMDPediatrics Physician

NPI Registry JSON

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

{
    "created_epoch": "1166054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1376605873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 N GLEBE RD",
            "address_2": "SUITE 300",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222033728",
            "telephone_number": "703-243-1300",
            "fax_number": "703-243-1151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 N GLEBE RD",
            "address_2": "SUITE 300",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222033728",
            "telephone_number": "703-243-1300",
            "fax_number": "703-243-1151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "SUSAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-14",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101240558",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "VA",
            "license": "0101240558",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.