SOO H. PARK (NPI# 1609819226) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609819226 |
| Entity Type | Individual |
| Full Name | SOO H. PARK |
| Credential | M.D. |
| Practice Address |
5330 E Stop 11 Rd Indianapolis IN 46237-6345 |
| Practice Telephone | 3178931900 |
| Practice Fax Number | 3178931901 |
| Mailing Telephone | 3178931900 |
| Mailing Fax Number | 3178931901 |
| Enumeration Date | 2006-06-13 |
| Last Update Date | 2016-09-13 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RI0011X |
Internal Medicine Specialization: Interventional Cardiology |
MD153728 | OR | Allopathic & Osteopathic Physicians |
| Y | 207RI0011X |
Internal Medicine Specialization: Interventional Cardiology |
01064126A | IN | Allopathic & Osteopathic Physicians |
| N | 207RI0011X |
Internal Medicine Specialization: Interventional Cardiology |
036042861 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | ANTHEM PIN | 000000984930 | 01 |
| IN | 200031190 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821351198 | Soo Park | Internal Medicine | Moores Ucsd Cancer Ctr, 3855 Health Sciences Drive, Mc-0829, La Jolla, CA 92093-0829 | 2012-06-20 |
| 1376669812 | Soo Min Park | Social Worker | 1310 Wilshire Blvd, Los Angeles, CA 90017-1705 | 2007-03-22 |
| 1124084728 | Soo Tae Park | Dentist | 44841 N 10th St W, Lancaster, CA 93534 | 2006-04-22 |
| Street Address |
5330 E STOP 11 RD |
| City | INDIANAPOLIS |
| State | IN |
| Zip Code | 46237-6345 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487651329 | Louis F. Janeira | Internal Medicine | 5330 E Stop 11 Rd, Indianapolis, IN 46237-6345 | 2005-07-07 |
| 1912542630 | Leanne Nichole Davis | Physician Assistant | 5330 E Stop 11 Rd, Indianapolis, IN 46237-6345 | 2019-11-18 |
| 1770126864 | Rachel Nicole Peterson | Physician Assistant | 5330 E Stop 11 Rd, Indianapolis, IN 46237-6345 | 2019-10-22 |
| 1215491261 | Raven P Cox | Registered Nurse | 5330 E Stop 11 Rd, Indianapolis, IN 46237-6345 | 2019-01-24 |
| 1528583606 | Lynda Jean Yousif | Physician Assistant | 5330 E Stop 11 Rd, Indianapolis, IN 46237 | 2017-08-09 |
| 1801337761 | Andra L. Meyers | Registered Nurse | 5330 E Stop 11 Rd, Indianapolis, IN 46237-6345 | 2017-03-13 |
| 1255780656 | Mallory Christine Larsen | Physician Assistant | 5330 E Stop 11 Rd, Indianapolis, IN 46237-6345 | 2016-06-07 |
| 1255707667 | Angie Howald | Nurse Practitioner | 5330 E Stop 11 Rd, Indianapolis, IN 46237-6345 | 2015-08-19 |
| 1689009441 | Casey Nicole Browning | Nurse Practitioner | 5330 E Stop 11 Rd, Indianapolis, IN 46237-6345 | 2013-09-11 |
| 1811333941 | George Lolay | Internal Medicine | 5330 E Stop 11 Rd, Indianapolis, IN 46237-6345 | 2013-05-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568961902 | Ashley Marie Mitchell | Nurse Practitioner | 8111 S Emerson Ave # 101, Indianapolis, IN 46237 | 2018-02-11 |
| 1245692177 | Christopher W Gregory | Pharmacist | 8111 S Emerson Avenue, Indianapolis, IN 46237 | 2016-03-21 |
| 1558729111 | Franklin Point Dental | Clinic/Center | 6751 E Southport Rd, Suite H, Indianapolis, IN 46237 | 2016-02-10 |
| 1821460767 | Costco Wholesale Corporation | Pharmacy | 4628 E County Line Rd, Indianapolis, IN 46237 | 2015-10-29 |
| 1164894697 | Mercedes Castellanos-pitcock | Physician Assistant | 7855 S Emerson Ave Ste P, Indianapolis, IN 46237 | 2015-10-23 |
| 1013301142 | Sophia Frawley | Physical Therapist | 7855 South Emerson Avenue, Suite W, Indianepolis, IN 46237 | 2015-03-26 |
| 1154715829 | Emily Marie Prather | Specialist/Technologist | 4607 Citation Cir, Indianapolis, IN 46237 | 2015-03-20 |
| 1659794543 | Rachel Adams | Occupational Therapy Assistant | 6525 Moss Creek Place, Indianapolis, IN 46237 | 2014-01-28 |
| 1790121549 | Carol Lynn Patton | Nurse Practitioner | 8111 S Emerson Ave Fl 5, Indianapolis, IN 46237 | 2013-05-21 |
| 1255685772 | Jarron J Lincoln | Physician Assistant | 5230 E Stop 11 Rd Ste 250, Indianapolis, IN 46237 | 2012-11-06 |
| Find all providers in zip 46237 | ||||
| Taxonomy Code | 207RI0011X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Interventional Cardiology |
| An area of medicine within the subspecialty of cardiology, which uses specialized imaging and other diagnostic techniques to evaluate blood flow and pressure in the coronary arteries and chambers of the heart and uses technical procedures and medications to treat abnormalities that impair the function of the cardiovascular system. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/ Board Certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. ACGME Accredited Residency Program Requirements: 1 year of training plus a prerequisite of 3 years Internal Medicine, 3 years Cardiovascular Disease for a total of 7 years. ABMS Approved Subspecialty Certificate (Internal Medicine) |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710485594 | Optimal Health Network of Indiana LLC | Internal Medicine | 120 E Market St Ste 1271, Indianapolis, IN 46204-3250 | 2018-01-26 |
| 1205275948 | Benjamin Thomas Maatman | Internal Medicine | 8075 N Shadeland Ave Ste 500, Indianapolis, IN 46250-2693 | 2013-06-16 |
| 1972065415 | Cind Care of In II, LLC | Internal Medicine | 120 E Market St Ste 1271, Indianapolis, IN 46204-3250 | 2019-04-03 |
| 1780868786 | Michael M Ross | Internal Medicine | 705 Riley Hospital Dr, Ri 1134, Indianapolis, IN 46202-5109 | 2007-12-27 |
| 1255448064 | Paul Terry Batties, Md, Inc. | Internal Medicine | 1633 N Capitol Ave, Suite #510, Indianapolis, IN 46202-1261 | 2006-08-25 |
| 1043327851 | Paul Terry Batties | Internal Medicine | 1801 N Senate Ave, Indianapolis, IN 46202 | 2006-08-25 |
| 1861427775 | Cccg, LLC | Internal Medicine | 1801 Senate Blvd, Methodist Professional Center, Suite 310, Indianapolis, IN 46202-1228 | 2006-07-11 |
| 1407828817 | Saeed R Shaikh | Internal Medicine | 5330 E Stop 11 Rd, Indianapolis, IN 46237-6345 | 2006-02-02 |
| 1225009749 | William J Berg | Internal Medicine | 5330 E Stop 11 Rd, Indianapolis, IN 46237-6345 | 2006-02-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730389586 | Akhtar Parvaiz Md | Internal Medicine | 1951 W 45th Ave, Griffith, IN 46319-3703 | 2007-07-20 |
| 1225058787 | William E Lehmkuhler, M.d. P.C. | Internal Medicine | 950 Memorial Dr, Jasper, IN 47546-2625 | 2006-07-20 |
| 1326073586 | Srinivasarao Manchikalapudi | Internal Medicine | 2109 Green Valley Rd, New Albany, IN 47150 | 2006-07-12 |
| 1548233158 | Kingsley Annan | Internal Medicine | 1928 S Dixon Rd, Kokomo, IN 46902-7302 | 2006-02-13 |
| 1194724377 | Eric F Schulte | Internal Medicine | 7863 Broadway, Suite 140, Merrillville, IN 46410-5553 | 2005-07-19 |
| 1386283281 | Seyal Cardiology LLC | Internal Medicine | 1455 Cedar St Ste D, Clarksville, IN 47129-7700 | 2019-12-26 |
| 1710440839 | 1st Choice Cardiovascular Associates LLC | Internal Medicine | 701 Superior Ave Ste J, Munster, IN 46321-4038 | 2019-04-08 |
| 1871094540 | Deaconess Specialty Physicians, Inc | Internal Medicine | 600 Mary St, Evansville, IN 47747-0001 | 2018-02-27 |
| 1396251468 | Lakeshore Cardiovascular Institute LLC | Internal Medicine | 8733 W 400 N, Michigan City, IN 46360 | 2017-12-27 |
| 1053782722 | Columbus Regional Health Physicians, LLC | Internal Medicine | 2325 18th St, Suite 130, Columbus, IN 47201-5387 | 2015-10-07 |
| Find all providers with the same taxonomy | ||||
| City | INDIANAPOLIS |
| Zip Code | 46237 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.