Individual provider Active NPI

Douglas Stephen Southern, PHD

  • Psychologist
  • Norman, OK
National Provider Identifier
1043407190
Registry record updated Mar 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
1445 Issued in OK
Practice address
15951 Little Axe Dr
Norman, OK 73026-9088
Phone
(405) 447-0300
NPI assigned
Oct 2, 2007
Last updated
Mar 25, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 0128981 NM
Psychologist 103T00000X 1445 OK Primary

Addresses

Primary practice location

15951 Little Axe Dr
Norman, OK 73026-9088

Mailing address

15951 Little Axe Dr
Norman, OK 73026-9088
Phone (405) 447-0300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251212001751 OK Practitioner - Clinical Psychologist 6901125111 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

15951 Little Axe Dr
Norman, OK 73026-9088
Phone (405) 447-0300

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0128981NMMDProfessional Counselor
1445OKMDGeneral Practice Dentistry
1353NMMDPeer Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Absentee Shawnee Tribal Health Authority, Inc. CurrentSince Nov 25, 2024 Accepting new patients
Absentee Shawnee Tribal Health Authority, Inc. Current Accepting new patients

Locations

15702 E State Highway 9
Norman, OK 73026
Phone (405) 447-0300

15951 Little Axe Dr
Norman, OK 73026
Phone (405) 447-0300

2029 Gordon Cooper Dr
Shawnee, OK 74801
Phone (405) 878-4702

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1191283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774396800000",
    "number": "1043407190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15951 LITTLE AXE DR",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730269088",
            "telephone_number": "405-447-0300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15951 LITTLE AXE DR",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730269088",
            "telephone_number": "405-447-0300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOUTHERN",
        "first_name": "DOUGLAS",
        "middle_name": "STEPHEN",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-10-02",
        "last_updated": "2026-03-25",
        "certification_date": "2026-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NM",
            "license": "0128981",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "OK",
            "license": "1445",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norman, OK

Sources for this page

Verify at the official NPI Registry.