Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Charlie Joon Park, CRNA

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1396409660

Charlie Joon Park, CRNA is a Certified Registered Nurse Anesthetist (CRNA) in Fort Worth, Texas. Qualified in 2021, 5 years ago. Practices with Cook Childrens Physician Network, a 301-clinician group and accepts Medicare assignment. Licensed in Texas.

Years since qualifying
5
Licensed in
TX
In the registry since
2021
Specialties on file
2
What do these letters mean?
CRNA — Certified Registered Nurse Anesthetist
An advanced practice nurse who administers anaesthesia.

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Practice location Address checks out

Student / training record This NPI belongs to someone enrolled in a health care training programme. It carries no licence and no practice of its own, so no address or phone number is published for it.

Fort Worth, TX
Fax: (682) 885-7497

Specialties & licences

Certified Registered Nurse Anesthetist (primary) Taxonomy 367500000X · Licence 1065201 (TX)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1396409660
Entity typeIndividual (Type 1)
GenderMale
Credentials CRNA
Sole proprietorNo
NPI enumeratedOctober 23, 2021
Last updated in NPPESMarch 2, 2022
Certification dateMarch 2, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCERTIFIED REGISTERED NURSE ANESTHETIST (CRNA)
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Cook Childrens Physician Network — 301 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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