Grace Song, P.A.

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

1450 E Valley Rd
Suite 201
Basalt, CO 81621-8304

Phone

(970) 927-8611

Fax

(970) 927-8633

NPI assigned

Sep 18, 2008

Last updated

Oct 4, 2013By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

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.

• Glendale Adventist Emergency Physicians Incorporated

  • Emergency Medicine Physician
  • Glendale, CA
  • NPI 1679907869
  Medicare reassignment
• Golden State Emergency Physicians Inc

  • Emergency Medicine Physician
  • Los Angeles, CA
  • NPI 1770886558
  Medicare reassignment
• Michael S. Agron, M.D., Inc.

  • Emergency Medicine Physician
  • Arcadia, CA
  • NPI 1699716100
  Medicare reassignment
• Cep America - California

  dba Vituity

  • Emergency Medicine Physician
  • Colton, CA
  • NPI 1306899166
  NPD (past)

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

{
    "created_epoch": "1221696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380844800000",
    "number": "1710136395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 CASTLE CREEK RD",
            "address_2": "SUITE 2100",
            "city": "ASPEN",
            "state": "CO",
            "postal_code": "816111159",
            "telephone_number": "970-925-4141",
            "fax_number": "970-927-8633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1450 E VALLEY RD",
            "address_2": "SUITE 201",
            "city": "BASALT",
            "state": "CO",
            "postal_code": "816218304",
            "telephone_number": "970-927-8611",
            "fax_number": "970-927-8633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SONG",
        "first_name": "GRACE",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-18",
        "last_updated": "2013-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Anne Skyler, MFT, PHD
• Jason D Slaver, DC
• Jenna Smith
• Karen Lajoy Smith, L.P.C.
• Sodawellness
• Sopris Chiropractic PC
• Sopris Medical Practice, P.C.
• Sopris Rehabilitation Services
• Jillian Standley, MA, LPCC
• Steadman Clinic Professional LLC (The Steadman Clinic)

• Physician Assistant in Basalt, CO
• Providers in Basalt, CO by specialty
• Physician Assistant in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2013; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.