NPIMap

Individual provider Active NPI

Pierce C. Park, MD

  • Nephrology Physician
  • Marquette, MI
National Provider Identifier
1477607638
Registry record updated Jun 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
4301103759 Issued in MI
Practice address
1414 W Fair Ave
Suite 344
Marquette, MI 49855-2675
Phone
(906) 225-3910
Fax
(906) 225-4529
NPI assigned
Jan 23, 2007
Last updated
Jun 26, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 35-092802 OH
Nephrology Physician 207RN0300X 4301103759 MI Primary

Addresses

Primary practice location

1414 W Fair Ave
Suite 344
Marquette, MI 49855-2675

Mailing address

1414 W Fair Ave
Suite 344
Marquette, MI 49855-2675
Phone (906) 225-3910

Other identifiers 1

IdentifierTypeStateIssuer
2949153MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, WI, MN3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20130917000213 MI Practitioner - NephrologyPractitioner - Internal Medicine 5496802118 Reassigns benefits to 1 organization
I20170328002282 WI Practitioner - NephrologyPractitioner - Internal Medicine 5496802118 Reassigns benefits to 1 organization
I20241213002988 MN Practitioner - Nephrology 5496802118 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
University of Chicago, Pritzker School of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St. Luke's Hospital of DuluthGroup PAC ID 7113834839, shared by 9 NPIs, 409 clinicians

Practice addresses (Care Compare)

1000 E 1St St
Duluth, MN 55805-2297

1011 E 1St St
Duluth, MN 55805-2242
Phone (218) 249-7000

1015 E 1St St
Duluth, MN 55805-2242
Phone (218) 249-7860

2201 Lake Shore Dr E
Ashland, WI 54806-2331
Phone (715) 685-6600

512 Skyline Blvd
Cloquet, MN 55720-3787
Phone (218) 879-4641

750 E 34TH St
Hibbing, MN 55746-2341
Phone (218) 262-4881

8373 Unity Dr
Virginia, MN 55792-4005
Phone (218) 748-7480

915 E 1St St
Duluth, MN 55805-2107
Phone (218) 249-5439

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35-092802OHMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Luke's Hospital of Duluth CurrentSince Dec 10, 2024 Accepting new patients
St. Luke's Hospital of Duluth CurrentSince Dec 10, 2024 Accepting new patients
DLP Marquette Physician Practices Inc CurrentSince Jun 26, 2013 Accepting new patients
DLP Marquette Physician Practices Inc CurrentSince Jun 26, 2013 Accepting new patients
St. Luke's Hospital of Duluth CurrentSince Sep 11, 2025 Accepting new patients
St. Luke's Hospital of Duluth Current Accepting new patients
St. Luke's Hospital of Duluth Current Accepting new patients
St. Luke's Hospital of Duluth Past Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

29980 Network Pl
Chicago, IL 60673

1414 W Fair Ave
Ste 344
Marquette, MI 49855
Phone (906) 225-3910

1414 W Fair Ave
Ste 36
Marquette, MI 49855
Phone (906) 225-3864

1015 E 1st St
Duluth, MN 55805
Phone (218) 249-7860

915 E 1st St
Duluth, MN 55805
Phone (218) 249-5352

2201 Lake Shore Dr E
Ashland, WI 54806
Phone (715) 685-6600

109 N 28th St E
Superior, WI 54880
Phone (715) 395-3900

Interoperability endpoints

  • Direct secure messaging: ppark359981@direct.aspirus.org

Organizations & group practices 9

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

Hospital & facility affiliations 46

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

View all 46

NPI Registry JSON

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372204800000",
    "number": "1477607638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1414 W FAIR AVE",
            "address_2": "SUITE 344",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "498552675",
            "telephone_number": "906-225-3910",
            "fax_number": "906-225-4529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1414 W FAIR AVE",
            "address_2": "SUITE 344",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "498552675",
            "telephone_number": "906-225-3910",
            "fax_number": "906-225-4529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "PIERCE",
        "middle_name": "C.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-23",
        "last_updated": "2013-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "OH",
            "license": "35-092802",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "MI",
            "license": "4301103759",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2949153",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marquette, MI

Sources for this page

Verify at the official NPI Registry.