Southern Medical Corporation PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

01033547A Issued in IN

Legal business name

SOUTHERN MEDICAL CORPORATION PC

Practice address

6433 E Washington St
Suite 125
Indianapolis, IN 46219-6677

Phone

(317) 923-1274

Fax

(317) 924-4436

NPI assigned

Sep 19, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Cheryle Dawn Southern, M.D.

Title

Physician

Phone

(317) 923-1274

Specialties & licenses 1

Addresses

Other identifiers 3

Locations

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

{
    "created_epoch": "1190160000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1449446400000",
    "number": "1093901480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6433 E WASHINGTON ST",
            "address_2": "SUITE 125",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462196677",
            "telephone_number": "317-923-1274",
            "fax_number": "317-924-4436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6433 E WASHINGTON ST",
            "address_2": "SUITE 125",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462196677",
            "telephone_number": "317-923-1274",
            "fax_number": "317-924-4436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN MEDICAL CORPORATION PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-19",
        "last_updated": "2015-12-07",
        "status": "A",
        "authorized_official_last_name": "SOUTHERN",
        "authorized_official_first_name": "CHERYLE",
        "authorized_official_middle_name": "DAWN",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "317-923-1274",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "01033547A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100237790A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000086109",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "110014372",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Southeast Neighborhood School of Excellence, Inc.
• Southeast Surgery Center LLC
• Brooke S. Southerland, PA-C
• Jara Lynn Southerland, NP
• Southern Hospitality Incorporated
• Thomas E Southern, MD
• Southpointe Pediatrics, PC
• Southport Adult Day Center
• Southport Dental, P.C.
• Southport Smiles Family and Cosmetic Dentistry

• Internal Medicine Physician in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Internal Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2015; 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.