Judy Southern

Primary specialty

Administrator Registered NurseTaxonomy code 163WA2000X

License

59604 Issued in NC

Practice address

1100 E Wendover Ave
Greensboro, NC 27405-6713

Phone

(336) 641-3712

Fax

(336) 641-6603

NPI assigned

Nov 23, 2010

Last updated

Nov 23, 2010By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1290470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1290470400000",
    "number": "1003118092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 E WENDOVER AVE",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274056713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 E WENDOVER AVE",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274056713",
            "telephone_number": "336-641-3712",
            "fax_number": "336-641-6603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOUTHERN",
        "first_name": "JUDY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-11-23",
        "last_updated": "2010-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WA2000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Administrator",
            "state": "NC",
            "license": "59604",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1245272657",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Southern Assisted Living, LLC. (Brookdale Northwest Greensboro)
• Southern Discount Drug, Inc. (Greensboro Discount Drug)
• Southern Family Markets LLC (Southern Family Market)
• Bethany Dare Southern Morris, LCSW
• Barry William Southern, R.PH.
• Brandon Sowell, MD
• Rebekah Sowers, PHARMD
• Space to Heal Counseling and Wellness, PLLC
• Linda D. Spagnola, RN, BSN, CDE
• Jeniffer Spagnolo

• Administrator Registered Nurse in Greensboro, NC
• Providers in Greensboro, NC by specialty
• Administrator Registered Nurse in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.