Kelly Southard

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

1953 Issued in SC

Practice address

3400 Anderson Rd Ste C
Greenville, SC 29611-7651

Phone

(864) 295-9890

NPI assigned

Apr 22, 2007

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Allegiant Pediatrics LLC

  • Pediatric Physical Therapist
  • Greenville, SC
  • NPI 1013306620
  NPD (past)
• The Care Center Inc.

  • Pediatric Physical Therapist
  • Greenville, SC
  • NPI 1326059288
  NPD (past)

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

{
    "created_epoch": "1177200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1114145653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 DUNHILL DR",
            "city": "ANDERSON",
            "state": "SC",
            "postal_code": "296255209",
            "telephone_number": "864-375-1235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 ANDERSON RD STE C",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296117651",
            "telephone_number": "864-295-9890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOUTHARD",
        "first_name": "KELLY",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "SC",
            "license": "1953",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• South Carolina Podiatric Physicians and Surgeons Group, LLC
• South Carolina Skin Cancer Center
• South Carolina United Psych LLC
• Christy Marie South, APRN, WHNP-BC
• Robert South, EMT
• Southeastern Dental Associates PA
• William Ernest Southerland, O. D.
• Southerlin Family Eye Care PA
• Southerlin Family Optical LLC
• Stephanie Southerlin, O.D.

• All providers in Greenville, SC
• Physical Therapy Assistant in South Carolina

• 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.