Sool Kee Song, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

7612 Issued in GA

Practice address

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

Phone

(404) 548-8850

NPI assigned

Jun 22, 2015

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

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, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northside Hospital Duluth Hospital, Duluth, GA, CCN 110252

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sool.song.p52@direct.tenet.nextgenshare.com

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.

• Pib Family Medicine

  • Family Medicine Physician
  • Duluth, GA
  • NPI 1801631247
  Medicare reassignment NPD Authorized official
• Woun Hue Seok DO PC

  • Family Medicine Physician
  • Duluth, GA
  • NPI 1821286956
  Medicare reassignment NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Northside Hospital, Inc.

  • General Acute Care Hospital
  • Duluth, GA
  • NPI 1790715381
  Care Compare affiliation

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

{
    "created_epoch": "1434931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724198400000",
    "number": "1891177382",
    "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": {
        "last_name": "SONG",
        "first_name": "SOOL",
        "middle_name": "KEE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-06-22",
        "last_updated": "2024-08-21",
        "certification_date": "2024-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "GA",
            "license": "80798",
            "primary": false
        },
        {
            "code": "207QA0000X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adolescent Medicine",
            "state": "GA",
            "license": "80798",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "7612",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chelsea Song, RPH
• Hanjoon Mike Song, MD
• Joseph Song, MA, MD
• Minsuk Song, DPT
• Samuel H Song, M.D.
• Yeohan Song, MD
• Marvis Latrice Sonnier, D.D.S.
• South Georgia Anesthesia Group, P.C.
• South Star Transport, Inc
• Southern Plastic Surgery, P.C.

• 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; 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.