Individual provider Active NPI

Hojoon Song, D.C.

  • Chiropractor
  • Charlotte, NC
National Provider Identifier
1164480067
Registry record updated Oct 25, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3236 Issued in NC
Practice address
2301 Rama Rd
Suite a
Charlotte, NC 28212-6237
Phone
(704) 566-6132
Fax
(704) 837-7353
NPI assigned
May 2, 2006
Last updated
Oct 25, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3236 NC Primary

Addresses

Primary practice location

2301 Rama Rd
Suite a
Charlotte, NC 28212-6237

Mailing address

2301 Rama Rd
Suite a
Charlotte, NC 28212-6237
Phone (704) 566-6132

Other identifiers 1

IdentifierTypeStateIssuer
89085UMMedicaidNC

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

State licenses

LicenseStateTypeSpecialty
3236NCMDClinical Psychologist

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1146528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319500800000",
    "number": "1164480067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2301 RAMA RD",
            "address_2": "SUITE A",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282126237",
            "telephone_number": "704-566-6132",
            "fax_number": "704-837-7353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 RAMA RD",
            "address_2": "SUITE A",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282126237",
            "telephone_number": "704-566-6132",
            "fax_number": "704-837-7353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SONG",
        "first_name": "HOJOON",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-02",
        "last_updated": "2011-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "3236",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89085UM",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.