Grace Song, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

35.142992 Issued in OH

Practice address

6450 Rivers Ave
North Charleston, SC 29406-4882

Phone

(843) 818-5100

NPI assigned

Mar 22, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in SC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Other, 2019

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Radiology Associates of Canton, Inc.

  • Diagnostic Radiology Physician
  • Canton, OH
  • NPI 1912982034
  NPD (past)

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

{
    "created_epoch": "1553212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788393600000",
    "number": "1255891529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "58 RED BLUFF ST",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294838222",
            "telephone_number": "330-780-0102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6450 RIVERS AVE",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "294064882",
            "telephone_number": "843-818-5100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1101 Greythorne Dr",
            "address_purpose": "LOCATION",
            "city": "Mount Pleasant",
            "state": "SC",
            "postal_code": "294666332",
            "country_code": "US",
            "telephone_number": "864-686-6163",
            "fax_number": "864-686-6166",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SONG",
        "first_name": "GRACE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-22",
        "last_updated": "2026-09-03",
        "certification_date": "2026-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35.142992",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Victor Dimetri Smith
• Gina Snell, RN
• John Snyder, DPT
• Todd Louis Snyder, MD
• Hanan Sokol, ATC
• Melissa Sue Soule, MA
• South Carolina CVS Pharmacy LLC (CVS Pharmacy #16950)
• South Carolina CVS Pharmacy LLC (CVS Pharmacy #03977)
• South Carolina CVS Pharmacy, L.L.C. (CVS Pharmacy # 00626)
• South Carolina Dept of Mental Health Accounting Office (Tricounty Crisis Stabilization Center)

• Family Medicine Physician in North Charleston, SC
• Providers in North Charleston, SC by specialty
• Family Medicine Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.