John G Southard, MD

Primary specialty

Pulmonary Disease PhysicianTaxonomy code 207RP1001X

License

22453 Issued in IA

Practice address

1 Edmundson PL
Suite 312
Council Bluffs, IA 51503-4658

Phone

(712) 396-4295

Fax

(712) 396-4298

NPI assigned

Feb 12, 2007

Sex

Male

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 2

Medicare fee-for-service enrollment

Enrolled in IA

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

Specialty

Pulmonary Disease

Education

Creighton University School of Medicine, 1978

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Methodist Jennie Edmundson Hospital, Council Bluffs, IA, CCN 160047
• Myrtue Medical Center Hospital, Harlan, IA, CCN 161374
• Cass County Memorial Hospital Hospital, Atlantic, IA, CCN 161376

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.

• Pulmonary Infectious Disease Associates PC

  • Pulmonary Disease Physician
  • Council Bluffs, IA
  • NPI 1083755821
  Medicare reassignment NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Cass County Memorial Hospital

  • Critical Access Hospital
  • Atlantic, IA
  • NPI 1093760944
  Care Compare affiliation
• Jennie Edmundson Memorial Hospital

  dba Methodist Jennie Edmundson

  • General Acute Care Hospital
  • Council Bluffs, IA
  • NPI 1457448755
  Care Compare affiliation
• Shelby County Chris a Myrtue Memorial Hospital

  dba Myrtue Medical Center

  • Critical Access Hospital
  • Harlan, IA
  • NPI 1598871469
  Care Compare affiliation

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

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104967090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 EDMUNDSON PL",
            "address_2": "SUITE 312",
            "city": "COUNCIL BLUFFS",
            "state": "IA",
            "postal_code": "515034658",
            "telephone_number": "712-396-4295",
            "fax_number": "712-396-4298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 EDMUNDSON PL",
            "address_2": "SUITE 312",
            "city": "COUNCIL BLUFFS",
            "state": "IA",
            "postal_code": "515034658",
            "telephone_number": "712-396-4295",
            "fax_number": "712-396-4298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOUTHARD",
        "first_name": "JOHN",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "IA",
            "license": "22453",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1133413",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "47244",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mike Snook, RPH
• Jeremy Matthew Snow, CRNA
• Jill Renee Sobczyk, P.A.-C
• Marcella Louise Sorrell, FNP
• Jorge F Sotolongo, M.D.
• Southerncare, Inc (SouthernCare Counsil Bluffs)
• Southwest Iowa Health Ventures PLLC (Cityscape Healthcare)
• Southwest Iowa Spine Care
• Southwest Orthodontic Associates, PC
• Specialized Support Services, Inc

• Pulmonary Disease Physician in Council Bluffs, IA
• Providers in Council Bluffs, IA by specialty
• Pulmonary Disease Physician in Iowa

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.