Active NPI
Kum Song, MD
- Radiation Oncology Physician
- Hudson, FL
National Provider Identifier
1093714362
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Radiation Oncology Physician
- License
- ME0048660
- Practice address
- 13904 Lakeshore Blvd
Ste 410
Hudson, FL 34667-1481 - Phone
- (727) 862-5489
- Fax
- (727) 862-0397
- NPI assigned
- Jul 19, 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 |
|---|---|---|---|---|
| Radiation Oncology Physician | 2085R0001X | ME0048660 | FL | Primary |
Addresses
Primary practice location
13904 Lakeshore Blvd
Ste 410
Hudson, FL 34667-1481
Mailing address
13904 Lakeshore Blvd
Ste 410
Hudson, FL 34667-1481
Phone (727) 862-5489
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 063864100 | 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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME0048660 | FL | MD | Radiation Oncology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1121731200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1328572800000",
"number": "1093714362",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13904 LAKESHORE BLVD",
"address_2": "STE 410",
"city": "HUDSON",
"state": "FL",
"postal_code": "346671481",
"telephone_number": "727-862-5489",
"fax_number": "727-862-0397"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13904 LAKESHORE BLVD",
"address_2": "STE 410",
"city": "HUDSON",
"state": "FL",
"postal_code": "346671481",
"telephone_number": "727-862-5489",
"fax_number": "727-862-0397"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SONG",
"first_name": "KUM",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-07-19",
"last_updated": "2012-02-07",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0001X",
"taxonomy_group": "",
"desc": "Radiology, Radiation Oncology",
"state": "FL",
"license": "ME0048660",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "063864100",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Hudson, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.