Julie Park, MD

Primary specialty

Pediatric Endocrinology PhysicianTaxonomy code 2080P0205X

License

MD197784 Issued in OR

Practice address

404 N Keene St
Women's and Children's Hospital
Columbia, MO 65201-6626

Phone

(573) 882-4438

Fax

(573) 884-9992

NPI assigned

Aug 6, 2016

Last updated

Aug 22, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

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

Pediatric Medicine

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Legacy Clinics LLCGroup PAC ID 0244144004, 714 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ohsu Hospital and Clinics Hospital, Portland, OR, CCN 380009
• Legacy Meridian Park Medical Center Hospital, Tualatin, OR, CCN 380089
• Legacy Silverton Medical Center Hospital, Silverton, OR, CCN 380029

Merit-based Incentive Payment System (MIPS)

Final score

94.62 of 100Reported as apm

Quality

77.21

Promoting interoperability

99.06

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Legacy Clinics LLC

  • Clinic/Center
  • Portland, OR
  • NPI 1902827272
  Medicare reassignment Care Compare group NPD
• Legacy Emanuel Hospital & Health Center

  • General Acute Care Hospital
  • Portland, OR
  • NPI 1831112358
  Medicare reassignment NPD
• Legacy Clinics LLC

  dba Legacy Medical Group Firwood

  • Rural Health Clinic/Center
  • Sandy, OR
  • NPI 1730472192
  NPD
• Legacy Emanuel Hospital & Health Center

  dba Apothecary at Emanuel Hospital

  • Community/Retail Pharmacy
  • Portland, OR
  • NPI 1417977976
  NPD
• Legacy Emanuel Hospital & Health Center

  • Clinic/Center
  • Portland, OR
  • NPI 1700809027

  Pediatrics

  NPD

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

• Legacy Meridian Park Hospital

  • General Acute Care Hospital
  • Tualatin, OR
  • NPI 1184647620
  Care Compare affiliation
• Oregon Health & Science University

  • General Acute Care Hospital
  • Portland, OR
  • NPI 1609824010
  Care Compare affiliation
• Silverton Health

  dba Legacy Silverton Medical Center

  • General Acute Care Hospital
  • Silverton, OR
  • NPI 1669424354
  Care Compare affiliation

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

{
    "created_epoch": "1470441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724284800000",
    "number": "1568916625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 N KEENE ST",
            "address_2": "SOUTH PAVILION",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652016626",
            "telephone_number": "573-882-4438",
            "fax_number": "573-884-9992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "404 N KEENE ST",
            "address_2": "WOMEN'S AND CHILDREN'S HOSPITAL",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652016626",
            "telephone_number": "573-882-4438",
            "fax_number": "573-884-9992"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "501 N Graham St Ste 375",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972272001",
            "country_code": "US",
            "telephone_number": "503-413-1600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PARK",
        "first_name": "JULIE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-08-06",
        "last_updated": "2024-08-22",
        "certification_date": "2024-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MO",
            "license": "2016022755",
            "primary": false
        },
        {
            "code": "2080P0205X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": "OR",
            "license": "MD197784",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John A Pardalos, M.D.
• Joseph Theressa Nehu Parimi, M.D.
• Christine Jeewan Park, MD
• Doris Park, MSN, RN. CS, FNP
• Eric Sung-Woo Park, MD
• Youngok Jade Park, M.D.
• Matthew Lee Parke, DO
• Beth R Parker, LCSW, ACSW
• Catherine Dore Parker, M.D.
• Charles Edward Parker, RRT

• Pediatric Endocrinology Physician in Columbia, MO
• Providers in Columbia, MO by specialty
• Pediatric Endocrinology Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.