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DR. KYEONGTAK SONG PHD, ATC
NPI 1053089482
Specialist/Technologist - Athletic Trainer in Lexington, KY

Active since August 31, 2021
720 SPORTS CENTER DRIVE, LEXINGTON, KY 40506(859) 323-9850 Get Directions Write a Review

NPPES record last updated: August 31, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dr. Kyeongtak Song Phd, Atc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. KYEONGTAK SONG PHD, ATC (NPI 1053089482) is an individual athletic trainer provider in Lexington, Kentucky and active in the NPI registry since August 2021.

NPPES Registry Identity

NPI1053089482
Entity TypeIndividualMale
Primary Taxonomy2255A2300X
Provider Legal NameDR. KYEONGTAK SONGCredential: PHD, ATC
Location Address720 SPORTS CENTER DRIVELexington, KY 40506-0001
Mailing Address2775 Polo Club Blvd Unit 305Lexington, KY 40509-8362 · (704) 497-0894
Phone(859) 323-9850
Sole ProprietorNo
Enumeration DateAugust 31, 2021
NPPES CertifiedAugust 31, 2021
✔ NPI 1053089482 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialist/Technologist · Athletic TrainerRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Taxonomy Code2255A2300X
Definition
Athletic trainers are allied health care professionals who work in consultation with or under the direction of physicians, and specialize in the prevention, assessment, treatment and rehabilitation of injuries and illnesses. Currently, the entry-level employment requirements are a bachelor's degree with a major in athletic training from an accredited university or college. A majority of athletic trainers hold advanced degrees. National board certification is generally required as a condition of state licensure and employment. Most states regulate athletic trainers, and they practice within the scope of that license or regulation. Clinical practice includes emergency care, rehabilitation, reconditioning, therapeutic exercise, wellness programs, exercise physiology, kinesiology, biomechanics, nutrition, psychology and health care administration.
720 SPORTS CENTER DRIVE, Lexington, KY 40506
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Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. NICHOLAS ROBERT HEEBNER PHD, ATC
Specialist/Technologist (Athletic Trainer)
720 SPORTS CENTER DRIVE, SPORTS MEDICINE RESEARCH INSTITUTE
LEXINGTON, KY 40506
Fayette County (859) 323-9850
JACOB D JELMINI LAT, ATC
Specialist/Technologist (Athletic Trainer)
720 SPORTS CENTER DRIVE
LEXINGTON, KY 40506
Fayette County (310) 426-0188

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kyeongtak Song's NPI number?

The NPI number for Kyeongtak Song is 1053089482. It was assigned to this individual provider in the NPPES registry on August 31, 2021.

Where is Kyeongtak Song located?

Kyeongtak Song practices at 720 Sports Center Drive, Lexington, KY 40506. The listed phone number is (859) 323-9850.

What is Kyeongtak Song's specialty?

The primary specialty registered for this NPI is Specialist/Technologist, specializing in Athletic Trainer, with taxonomy code 2255A2300X.

When was this NPI record last updated?

The NPPES record for Kyeongtak Song was last updated on August 31, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.