Individual provider Active NPI

Sojung Kara Park, DO

  • Neurology Physician
  • Charleston, WV
National Provider Identifier
1386260438
Registry record updated Sep 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
4715 Issued in WV
Practice address
415 Morris St Ste 300
Charleston, WV 25301-1853
Phone
(304) 388-6441
NPI assigned
Jun 24, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 4715 WV Primary

Addresses

Primary practice location

415 Morris St Ste 300
Charleston, WV 25301-1853

Mailing address

415 Morris St Ste 300
Charleston, WV 25301-1853
Phone (304) 388-6441

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, WV2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20240613003650 MI Practitioner - Neurology 3476977463 Reassigns benefits to 1 organization
I20251016003569 WV Practitioner - Neurology 3476977463 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Michigan State University College of Osteopathic Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

415 Morris St
Suite 300
Charleston, WV 25301-1853
Phone (304) 388-6441

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Charleston Area Medical Center, Inc. CurrentSince Aug 26, 2025 Accepting new patients
University Physician Group Internal Medicine CurrentSince Aug 1, 2024 Accepting new patients
Charleston Area Medical Center Inc CurrentSince Aug 26, 2025 Accepting new patients
Charleston Area Medical Center Inc Past Accepting new patients

Locations

4201 Saint Antoine St
Ste 8A
Detroit, MI 48201
Phone (313) 577-8114

4100 John R St
Detroit, MI 48201
Phone (313) 576-8530

400 Mack Ave
Detroit, MI 48201
Phone (313) 448-9006

1560 E Maple Rd
Ste 200
Troy, MI 48083
Phone (248) 581-5200

415 Morris St
Ste 300
Charleston, WV 25301
Phone (304) 345-6303

501 Morris St
Charleston, WV 25301
Phone (304) 348-6293

Organizations & group practices 4

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.

Hospital & facility affiliations 11

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

NPI Registry JSON

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

{
    "created_epoch": "1592956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759190400000",
    "number": "1386260438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 MORRIS ST STE 300",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253011853",
            "telephone_number": "304-388-6441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 MORRIS ST STE 300",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253011853",
            "telephone_number": "304-388-6441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "SOJUNG",
        "middle_name": "KARA",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-24",
        "last_updated": "2025-09-30",
        "certification_date": "2025-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "WV",
            "license": "4715",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, WV

Sources for this page

Verify at the official NPI Registry.