Active NPI
David Song Ko, DO
- Family Medicine Physician
- Putnam, CT
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 0102205469
- Practice address
- 330 Pomfret St
Putnam, CT 06260-3803 - Phone
- (860) 928-2736
- NPI assigned
- May 27, 2015
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | OP61443176 | WA | |
| Family Medicine Physician | 207Q00000X | 0102205469 | VA | Primary |
| Family Medicine Physician | 207Q00000X | 82804 | CT |
Addresses
Primary practice location
330 Pomfret St
Putnam, CT 06260-3803
Mailing address
PO Box 746871
Atlanta, GA 30374-6871
Other practice location 1
55 W Tietan St
Walla Walla, WA 99362-4445
Phone (540) 825-6263
Other practice location 2
1800A Frederick Blvd
Portsmouth, VA 23707-4618
Phone (757) 337-6000
Other practice location 3
2690 NE Kresky Ave
Chehalis, WA 98532-2412
Phone (360) 330-9595
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in VA, OR, CT
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 3
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Other, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
1800 A Frederick Blvd
Portsmouth, VA 23707-4618
Phone (757) 337-6000
330 Pomfret St
Putnam, CT 06260-1854
Phone (860) 928-2736
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 82804 | CT | MD | Family Medicine Physician |
| 0102205469 | VA | MD | Family Medicine Physician |
| OP61443176 | WA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Osh-VA Physicians Group PLLC | Family Medicine | Current | Accepting new patients |
| University of Virginia Physicians Group | Current | Accepting new patients | |
| Prohealth Physicians PC | Family Medicine | Current | Accepting new patients |
Locations
330 Pomfret St
Putnam, CT 06260
Phone (860) 928-2736
115 Spencer St
Winsted, CT 06098
Phone (860) 738-5810
1215 Lee St
Fl 1
Charlottesville, VA 22908
Phone (434) 924-9400
1215 Lee St
Fl 8
Charlottesvle, VA 22908
Phone (434) 924-2500
16268 Bennett Rd
Culpeper, VA 22701
Phone (540) 825-6263
6206 N Military Hwy
Ste H
Norfolk, VA 23518
Phone (757) 271-5282
1800 Frederick Blvd
#A
Portsmouth, VA 23707
Phone (757) 337-6000
3900 Hull St Rd
Richmond, VA 23224
Phone (804) 292-7620
Organizations & group practices 4
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.
-
- Family Medicine Physician
- Farmington, CT
- NPI 1720194053
-
- Sports Medicine (Neuromusculoskeletal Medicine) Physician
- Charlottesville, VA
- NPI 1033138250
-
- Federally Qualified Health Center (FQHC)
- Cornelius, OR
- NPI 1679528012
Hospital & facility affiliations 12
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Putnam, CT
- NPI 1205056371
-
- General Acute Care Hospital
- Putnam, CT
- NPI 1649243478
-
- General Acute Care Hospital
- Portsmouth, VA
- NPI 1750399192
-
- General Acute Care Hospital
- Norfolk, VA
- NPI 1811957681
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1432684800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1776729600000",
"number": "1356720049",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 746871",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303746871"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "330 POMFRET ST",
"city": "PUTNAM",
"state": "CT",
"postal_code": "062603803",
"telephone_number": "860-928-2736"
}
],
"practiceLocations": [
{
"address_1": "55 W Tietan St",
"address_purpose": "LOCATION",
"city": "Walla Walla",
"state": "WA",
"postal_code": "993624445",
"country_code": "US",
"telephone_number": "540-825-6263",
"fax_number": "540-825-4911",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1800A Frederick Blvd",
"address_purpose": "LOCATION",
"city": "Portsmouth",
"state": "VA",
"postal_code": "237074618",
"country_code": "US",
"telephone_number": "757-337-6000",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2690 NE Kresky Ave",
"address_purpose": "LOCATION",
"city": "Chehalis",
"state": "WA",
"postal_code": "985322412",
"country_code": "US",
"telephone_number": "360-330-9595",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KO",
"first_name": "DAVID",
"middle_name": "SONG",
"name_prefix": "Dr.",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-05-27",
"last_updated": "2026-04-21",
"certification_date": "2026-04-21",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "WA",
"license": "OP61443176",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "VA",
"license": "0102205469",
"primary": true
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "CT",
"license": "82804",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Putnam, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 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.