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KATHY SONG PA-C
NPI 1396095360
Physician Assistant - Medical in Stroud, OK

Active since September 17, 2012PECOS Enrolled
356110 E 930 RD, STROUD, OK 74079(918) 968-9531 Get Directions Write a Review

NPPES record last updated: September 3, 2019. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Kathy Song Pa-c NPPES

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

KATHY SONG PA-C (NPI 1396095360) is an individual medical provider in Stroud, Oklahoma, licensed in Alabama (1287) and active in the NPI registry since September 2012. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1396095360
Entity TypeIndividualFemale
Primary Taxonomy363AM0700X
Provider Legal NameKATHY SONGCredential: PA-C
Location Address356110 E 930 RDStroud, OK 74079-5184
Mailing Address2868 Acton RdVestavia, AL 35243-2502 · (205) 379-6075 · Fax (866) 702-0880
Phone(918) 968-9531
Sole ProprietorNo
Enumeration DateSeptember 17, 2012
Last NPPES UpdateSeptember 3, 2019
✔ NPI 1396095360 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AM0700X
Licenses✔ Licensed in AL · 1287✔ Licensed in OK · 2160
356110 E 930 RD, Stroud, OK 74079
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kathy Song Pa-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 18

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

CIERRA R KEFFER
Peer Specialist
356110 E 930 RD
STROUD, OK 74079
Lincoln County (918) 968-9531
STACEY MICHELLE LEATHERS
Peer Specialist
356110 E 930 RD
STROUD, OK 74079
Lincoln County (918) 208-8655
MRS. BETHANY CAROLEE ROLLINS APRN, FNP-C
Nurse Practitioner (Family)
356110 E 930 RD
STROUD, OK 74079
Lincoln County (918) 968-9531
CIERRA DAWN LAYMAN LPN
Licensed Practical Nurse
356110 E 930 RD
STROUD, OK 74079
Lincoln County (918) 968-9531
GARY R. KINDELL M.D.
Family Medicine
356110 E 930 RD
STROUD, OK 74079
Lincoln County (918) 968-9531
ASHLEE DAWN MORGAN PRSS
Peer Specialist
356110 E 930 RD
STROUD, OK 74079
Lincoln County (918) 968-9531
TYLER AUSTIN ROLETTE D.P.T.
Physical Therapist
356110 E 930 RD
STROUD, OK 74079
Lincoln County (918) 968-9531
DR. GREGORY DUNLEVY PT, DPT, CSCS
Physical Therapist
356110 E 930 RD
STROUD, OK 74079
Lincoln County (918) 968-9531

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 Kathy Song's NPI number?

The NPI number for Kathy Song is 1396095360. It was assigned to this individual provider in the NPPES registry on September 17, 2012.

Where is Kathy Song located?

Kathy Song practices at 356110 E 930 Rd, Stroud, OK 74079. The listed phone number is (918) 968-9531.

What is Kathy Song's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Is Kathy Song enrolled in Medicare?

Yes. Kathy Song is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Kathy Song was last updated on September 3, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.