Bonita Marie Southard

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

License

085586459 Issued in TN

Practice address

620 Gallatin Pike S
Madison, TN 37115-4013

Phone

(615) 460-4300

Fax

(615) 460-4380

NPI assigned

Jan 27, 2010

Last updated

Jan 27, 2010By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

State licenses

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

{
    "created_epoch": "1264550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264550400000",
    "number": "1124359450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 GALLATIN PIKE S",
            "city": "MADISON",
            "state": "TN",
            "postal_code": "371154013",
            "telephone_number": "615-460-4300",
            "fax_number": "615-460-4380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 GALLATIN PIKE S",
            "city": "MADISON",
            "state": "TN",
            "postal_code": "371154013",
            "telephone_number": "615-460-4300",
            "fax_number": "615-460-4380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOUTHARD",
        "first_name": "BONITA",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-01-27",
        "last_updated": "2010-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "TN",
            "license": "085586459",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Case Manager/Care Coordinator in Madison, TN
• Providers in Madison, TN by specialty
• Case Manager/Care Coordinator in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2010; 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.