Charles Park, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

MD227125 Issued in OR

Practice address

2301 Clairmont Dr
Klamath Falls, OR 97601-7104

Phone

(541) 274-2345

Fax

(541) 274-6247

NPI assigned

May 29, 2007

Last updated

Oct 30, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

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

General Surgery

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sky Lakes Medical Center IncGroup PAC ID 1052204096, 196 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sky Lakes Medical Center Hospital, Klamath Falls, OR, CCN 380050

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: cpark137957@direct.uchealth.com

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.

• Sky Lakes Medical Center Inc

  • General Acute Care Hospital
  • Klamath Falls, OR
  • NPI 1659340370
  Medicare reassignment Care Compare group NPD
• Sky Lakes Medical Center Inc

  dba Sky Lakes Specialty Pharmacy

  • Community/Retail Pharmacy
  • Klamath Falls, OR
  • NPI 1003654625
  NPD

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

• Sky Lakes Medical Center Inc

  • Occupational Therapist
  • Klamath Falls, OR
  • NPI 1134270911

  Hospital

  Care Compare affiliation
• Sky Lakes Medical Center Inc

  • General Acute Care Hospital
  • Klamath Falls, OR
  • NPI 1659340370
  Care Compare affiliation

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

{
    "created_epoch": "1180396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761782400000",
    "number": "1972704096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2865 DAGGETT AVE FL 4",
            "city": "KLAMATH FALLS",
            "state": "OR",
            "postal_code": "976011106",
            "telephone_number": "541-274-2345",
            "fax_number": "541-274-6247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 CLAIRMONT DR",
            "city": "KLAMATH FALLS",
            "state": "OR",
            "postal_code": "976017104",
            "telephone_number": "541-274-2345",
            "fax_number": "541-274-6247"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "234 Goodman St",
            "address_purpose": "LOCATION",
            "city": "Cincinnati",
            "state": "OH",
            "postal_code": "452192364",
            "country_code": "US",
            "telephone_number": "513-475-8787",
            "fax_number": "513-558-3136",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PARK",
        "first_name": "CHARLES",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-29",
        "last_updated": "2025-10-30",
        "certification_date": "2025-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MA",
            "license": "249748",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "OH",
            "license": "35.126455",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "OR",
            "license": "MD227125",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0151480",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Heidi Page, PHD
• Kim Palmer
• Vincent Paulo Formalejo Panganiban, PT
• David H Panossian, MD
• Elizabeth Panuco
• Parker B Mah Chiropractic PC
• Parker B. Mah Chiropractic P.C.
• Doneen Ethazel Parker
• Grace Parker, LMT
• Jodie Lynn Parker

• Surgery Physician in Klamath Falls, OR
• Providers in Klamath Falls, OR by specialty
• Surgery Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2025; 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.