Carol A Soutor, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

24028 Issued in MN

Practice address

401 Phalen Blvd - Ms 41102B
Healthpartners Specialty Center 401
St. Paul, MN 55130-5302

Phone

(651) 254-7580

Fax

(651) 254-7584

NPI assigned

Feb 27, 2006

Sex

Female

Sole proprietor

No

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

Enrolled in MN

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Fairview Express Care

  • Multi-Specialty Clinic/Center
  • Minneapolis, MN
  • NPI 1053952606
  Medicare reassignment NPD
• Group Health, Inc.

  • Multi-Specialty Clinic/Center
  • Minneapolis, MN
  • NPI 1710924683
  Medicare reassignment NPD
• Fairview Express Care

  • General Practice Physician
  • Edina, MN
  • NPI 1831707207
  NPD
• Group Health, Inc.

  • Pediatric Dentistry
  • Minneapolis, MN
  • NPI 1700932449
  NPD
• Group Health, Inc.

  • General Practice Dentistry
  • Saint Paul, MN
  • NPI 1952042053
  NPD

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

{
    "created_epoch": "1140998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323820800000",
    "number": "1023084241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8170 33RD AVE S",
            "address_2": "MS21110Q",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554254516",
            "telephone_number": "952-883-5375",
            "fax_number": "651-254-7584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 PHALEN BLVD - MS 41102B",
            "address_2": "HEALTHPARTNERS SPECIALTY CENTER 401",
            "city": "ST. PAUL",
            "state": "MN",
            "postal_code": "551305302",
            "telephone_number": "651-254-7580",
            "fax_number": "651-254-7584"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOUTOR",
        "first_name": "CAROL",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-27",
        "last_updated": "2011-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MN",
            "license": "24028",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "841582000",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• South Metro Human Services- TCM
• South Metro Human Services-Act Blue
• South Metro Human Services-Act Purple
• Southview Acres Health Care Center Inc
• Southview Senior Living
• Ashley Elizabeth Sovereign, PSY.D
• John Sowada, MA
• James M Soyka, M.D.
• SP Spine Center P a
• Kevin Gawain Spaeth

• Dermatology Physician in St. Paul, MN
• Providers in St. Paul, MN by specialty
• Dermatology Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2011; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.