Pib Family Medicine

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

PIB FAMILY MEDICINE

Doing business as

Song Family Medicine

Practice address

2730 Peachtree Industrial Blvd Ste 101
Duluth, GA 30097-8627

Phone

(404) 548-8850

NPI assigned

Jun 27, 2024

Last updated

Aug 21, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Sool Kee Song, MDNPI 1891177382

Title

Owner/Physician

Phone

(404) 897-0684

Specialties & licenses 1

Addresses

Other names 1

• Song Family Medicine Doing business as

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Sool Kee Song, MD

  • Family Medicine Physician
  • Duluth, GA
  • NPI 1891177382
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1719446400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724198400000",
    "number": "1801631247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2730 PEACHTREE INDUSTRIAL BLVD STE 101",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300978627",
            "telephone_number": "404-897-0684",
            "fax_number": "404-897-0729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2730 PEACHTREE INDUSTRIAL BLVD STE 101",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300978627",
            "telephone_number": "404-548-8850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PIB FAMILY MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-27",
        "last_updated": "2024-08-21",
        "certification_date": "2024-08-21",
        "status": "A",
        "authorized_official_last_name": "SONG",
        "authorized_official_first_name": "SOOL",
        "authorized_official_middle_name": "KEE",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "404-897-0684",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Song Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Jina Pierre
• Patrina Pinder, CSFA
• Victoria Joanna Pinell
• Adriunna Pinnock, M.S.

• Family Medicine Physician in Duluth, GA
• Providers in Duluth, GA by specialty
• Family Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.