Individual provider Active NPI

Stephen K Souther, M.D.

  • Cardiovascular Disease Physician
  • Knoxville, TN
National Provider Identifier
1124022017
Registry record updated Jul 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
044108 Issued in GA
Practice address
8033 Ray Mears Blvd
Knoxville, TN 37919
Phone
(865) 545-4592
NPI assigned
Jun 8, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 44108 GA
Cardiovascular Disease Physician 207RC0000X 044108 GA Primary

Addresses

Primary practice location

8033 Ray Mears Blvd
Knoxville, TN 37919

Mailing address

115 Nantahala Drive
Townsend, TN 37882
Phone (229) 869-8898

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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

Enrollment IDStateProvider typePAC IDDetails
I20051025000950 GA Practitioner - Cardiovascular Disease (Cardiology) 0547169302 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
44108GAMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Phoebe Orthopedic Specialists CurrentSince Jul 1, 2009 Accepting new patients
Phoebe Putney Memorial Hospital Inc Current Accepting new patients
Phoebe Physician Group, Inc CurrentSince Jul 1, 2009 Accepting new patients
Cardiology Associates PC Specialist Current Accepting new patients
Phoebe Putney Memorial Hospital, Inc. Past Accepting new patients
Phoebe Putney Memorial Hospital, Inc. Past Accepting new patients
Hospital Authority of the City of Bainbridge and Decatur County Past Accepting new patients

Locations

417 W 3rd Ave
Albany, GA 31701
Phone (229) 317-2207

500 W 3rd Ave
Ste 101
Albany, GA 31701
Phone (229) 312-5802

425 W 3rd Ave
Albany, GA 31701
Phone (229) 312-0344

425 W 3rd Ave
Ste 600
Albany, GA 31701
Phone (229) 431-1022

2002 Palmyra Rd
Ste 201
Albany, GA 31701
Phone (229) 312-5802

151 Mayo St
Ste B
Americus, GA 31709
Phone (229) 928-2900

3131 Thomasville Hwy
Moultrie, GA 31768
Phone (229) 502-9769

Organizations & group practices 7

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": "1118188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531094400000",
    "number": "1124022017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 NANTAHALA DRIVE",
            "city": "TOWNSEND",
            "state": "TN",
            "postal_code": "37882",
            "telephone_number": "229-869-8898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8033 RAY MEARS BLVD",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "37919",
            "telephone_number": "865-545-4592"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOUTHER",
        "first_name": "STEPHEN",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-08",
        "last_updated": "2018-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "GA",
            "license": "44108",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "GA",
            "license": "044108",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

Verify at the official NPI Registry.