Active NPI
Billy Sana Kong, MD
- Family Medicine Physician
- Bartow, FL
National Provider Identifier
1003804568
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- ME50150
- Practice address
- 1255 Brice Blvd
Bartow, FL 33830-6735 - Phone
- (863) 519-8233
- Fax
- (863) 519-8304
- NPI assigned
- Oct 10, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | ME50150 | FL | Primary |
Addresses
Primary practice location
1255 Brice Blvd
Bartow, FL 33830-6735
Mailing address
1290 Golfview Ave
4TH Floor Billing Department
Bartow, FL 33830-6738
Phone (863) 519-7900
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 061584600 | Medicaid | FL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University Medical Service Association Inc | Past | Accepting new patients |
Organizations & group practices 1
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.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1128902400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1281484800000",
"number": "1003804568",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1290 GOLFVIEW AVE",
"address_2": "4TH FLOOR BILLING DEPARTMENT",
"city": "BARTOW",
"state": "FL",
"postal_code": "338306738",
"telephone_number": "863-519-7900",
"fax_number": "863-519-7696"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1255 BRICE BLVD",
"city": "BARTOW",
"state": "FL",
"postal_code": "338306735",
"telephone_number": "863-519-8233",
"fax_number": "863-519-8304"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KONG",
"first_name": "BILLY",
"middle_name": "SANA",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-10-10",
"last_updated": "2010-08-11",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "FL",
"license": "ME50150",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "061584600",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bartow, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.