Individual provider Active NPI

Joseph C Souther, MD

  • Family Medicine Physician
  • Winder, GA
National Provider Identifier
1043370638
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
015425 Issued in GA
Practice address
251 E Broad St
Winder, GA 30680-2206
Phone
(770) 867-9181
Fax
(770) 867-4817
NPI assigned
Dec 12, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 015425 GA Primary

Addresses

Primary practice location

251 E Broad St
Winder, GA 30680-2206

Mailing address

251 E Broad St
Winder, GA 30680-2206
Phone (770) 867-9181

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
015425GAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Winder Medical PA PastSince Jul 1, 1966 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1043370638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "251 E BROAD ST",
            "city": "WINDER",
            "state": "GA",
            "postal_code": "306802206",
            "telephone_number": "770-867-9181",
            "fax_number": "770-867-4817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "251 E BROAD ST",
            "city": "WINDER",
            "state": "GA",
            "postal_code": "306802206",
            "telephone_number": "770-867-9181",
            "fax_number": "770-867-4817"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOUTHER",
        "first_name": "JOSEPH",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "015425",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winder, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.