Brian Park, M.D.

Primary specialty

Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X

License

25MA1085990 Issued in NJ

Practice address

Camc - Pulmonary and Critical Care Medicine
3200 Maccorkle Ave SE
Charleston, WV 25304

Phone

(201) 978-9388

NPI assigned

May 12, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ, 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

Specialty

Critical Care (Intensivists)

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Charleston Area Medical Center IncGroup PAC ID 3375441637, 969 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Charleston Area Medical Center Hospital, Charleston, WV, CCN 510022

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: bpark35006@direct.cooperhealth.edu

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.

• Charleston Area Medical Center, Inc.

  • General Acute Care Hospital
  • Charleston, WV
  • NPI 1124248752
  Medicare reassignment Care Compare group NPD
• CMC Department of Medicine Group PA

  • Cardiovascular Disease Physician
  • Camden, NJ
  • NPI 1609908094
  Medicare reassignment NPD
• Cooper Physician Offices, PA

  • Internal Medicine Physician
  • Camden, NJ
  • NPI 1154369510
  Medicare reassignment NPD
• CMC Department of Medicine Group PA

  • Critical Care Medicine (Internal Medicine) Physician
  • Camden, NJ
  • NPI 1679605554
  Medicare reassignment
• Charleston Area Medical Center Inc

  • Multi-Specialty Clinic/Center
  • Belpre, OH
  • NPI 1588422547
  NPD
• Charleston Area Medical Center Inc

  • General Acute Care Hospital
  • Charleston, WV
  • NPI 1952390239
  NPD (past)

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

• Charleston Area Medical Center Inc

  • Psychiatric Hospital Unit
  • Charleston, WV
  • NPI 1265421226
  Care Compare affiliation
• Charleston Area Medical Center Inc

  • General Acute Care Hospital
  • Beckley, WV
  • NPI 1427904002
  Care Compare affiliation
• Charleston Area Medical Center Inc

  • General Acute Care Hospital
  • Beckley, WV
  • NPI 1508712118
  Care Compare affiliation
• Charleston Area Medical Center Inc

  • Rehabilitation Hospital Unit
  • Charleston, WV
  • NPI 1639168693
  Care Compare affiliation
• Charleston Area Medical Center Inc

  • General Acute Care Hospital
  • Beckley, WV
  • NPI 1689520264
  Care Compare affiliation
• Charleston Area Medical Center Inc

  • General Acute Care Hospital
  • Fayetteville, WV
  • NPI 1932055589
  Care Compare affiliation
• Charleston Area Medical Center Inc

  • General Acute Care Hospital
  • Charleston, WV
  • NPI 1952390239
  Care Compare affiliation
• Charleston Area Medical Center, Inc.

  • General Acute Care Hospital
  • Charleston, WV
  • NPI 1124248752
  Care Compare affiliation
• Charleston Area Medical Center, Inc.

  • Community/Retail Pharmacy
  • Charleston, WV
  • NPI 1134518186

  Hospital

  Care Compare affiliation
• Charleston Area Medical Center, Inc.

  • Hospitalist Physician
  • Ronceverte, WV
  • NPI 1972125995
  Care Compare affiliation
• Charleston Medical Center, Inc.

  • General Acute Care Hospital
  • Fayetteville, WV
  • NPI 1174479513
  Care Compare affiliation

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

{
    "created_epoch": "1494547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714089600000",
    "number": "1942737697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "COOPER HEALTH GRADUATE MEDICAL EDUCATION",
            "address_2": "ONE COOPER PLZ",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "08103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CAMC - PULMONARY AND CRITICAL CARE MEDICINE",
            "address_2": "3200 MACCORKLE AVE SE",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "25304",
            "telephone_number": "201-978-9388"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "CUHS Dept of Critical Care Medicine Fellowship",
            "address_2": "One Cooper Plz",
            "address_purpose": "LOCATION",
            "city": "Camden",
            "state": "NJ",
            "postal_code": "08103",
            "country_code": "US",
            "telephone_number": "856-342-9647",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PARK",
        "first_name": "BRIAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-12",
        "last_updated": "2024-04-26",
        "certification_date": "2024-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "WV",
            "license": "33603",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD468574",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "NJ",
            "license": "25MA1085990",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Harold Pannell
• Luegenia Pannell
• Makesha Pannell
• Toni Renee Pantoja, PRSS
• Krista Parcell, CNM
• Ji Yoon Park, M.D.
• Sojung Kara Park, DO
• Brandie Parker
• Brooke Ann Parker, LICSW
• Clark Parker, RPH

• Critical Care Medicine (Internal Medicine) Physician in Charleston, WV
• Providers in Charleston, WV by specialty
• Critical Care Medicine (Internal Medicine) Physician in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 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.