Individual provider Active NPI

Daniel O Southern, MD

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Norwalk, CT
National Provider Identifier
1154346302
Registry record updated Dec 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X
License
042845 Issued in CT
Practice address
91 East Ave Ste 1a
Norwalk, CT 06851-5020
Phone
(203) 456-5717
Fax
(203) 445-6184
NPI assigned
Jul 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 042845 CT
Pain Medicine (Physical Medicine & Rehabilitation) Physician 2081P2900X 042845 CT Primary
Pain Medicine Physician 208VP0000X 042845 CT

Addresses

Primary practice location

91 East Ave Ste 1a
Norwalk, CT 06851-5020

Mailing address

91 East Ave Ste 1a
Norwalk, CT 06851-5020
Phone (203) 456-5717

Other practice location 1

195 Danbury Road, Suite B220
Wilton, CT 06897
Phone (203) 456-5717

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20041124000551 CT Practitioner - Physical Medicine and Rehabilitation 3173505856 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
State University of Ny Upstate Medical University, 1999
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

195 Danbury Rd
Suite 220
Wilton, CT 06897-4075

91 E Ave
Suite 1a
Norwalk, CT 06851-5020
Phone (203) 456-5717

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
042845CTMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Interventional Orthopedics CT, P.C Pain Medicine CurrentSince Nov 15, 2019 Accepting new patients
Orthoconnecticut, PLLC Past Accepting new patients

Locations

91 East Ave
Ste 1A
Norwalk, CT 06851
Phone (203) 456-5717

195 Danbury Rd
Ste 220
Wilton, CT 06897
Phone (203) 456-5717

195 Danbury Rd
Ste B220
Wilton, CT 06897
Phone (203) 456-5717

Interoperability endpoints

  • Direct secure messaging: dsouthern@doa1744.srs-direct.com

Organizations & group practices 2

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": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765756800000",
    "number": "1154346302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "91 EAST AVE STE 1A",
            "city": "NORWALK",
            "state": "CT",
            "postal_code": "068515020",
            "telephone_number": "203-456-5717",
            "fax_number": "203-445-6184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "91 EAST AVE STE 1A",
            "city": "NORWALK",
            "state": "CT",
            "postal_code": "068515020",
            "telephone_number": "203-456-5717",
            "fax_number": "203-445-6184"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "195 Danbury Road, Suite B220",
            "address_purpose": "LOCATION",
            "city": "Wilton",
            "state": "CT",
            "postal_code": "06897",
            "country_code": "US",
            "telephone_number": "203-456-5717",
            "fax_number": "203-445-6184",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SOUTHERN",
        "first_name": "DANIEL",
        "middle_name": "O",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2025-12-15",
        "certification_date": "2025-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "CT",
            "license": "042845",
            "primary": false
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "CT",
            "license": "042845",
            "primary": true
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "CT",
            "license": "042845",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norwalk, CT

Sources for this page

Verify at the official NPI Registry.