NPIMap

Individual provider Active NPI

Christopher John Southwood, M.D.

  • Neurocritical Care Physician
  • Mobile, AL
National Provider Identifier
1215270616
Registry record updated Jan 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurocritical Care PhysicianTaxonomy code 2084A2900X
License
45096 Issued in AL
Practice address
1720 Spring Hill Ave Ste 300
Mobile, AL 36604-1409
Phone
(251) 435-1200
Fax
(251) 435-6357
NPI assigned
Apr 3, 2013
Last updated
Jan 11, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 63355 WI
Vascular Neurology Physician 2084V0102X 45096 AL
Neurocritical Care Physician 2084A2900X 45096 AL Primary

Addresses

Primary practice location

1720 Spring Hill Ave Ste 300
Mobile, AL 36604-1409

Mailing address

1700 Spring Hill Ave Ste 100
Mobile, AL 36604-1416
Phone (251) 435-1200

Other practice location 1

8701 W Watertown Plank Rd
Milwaukee, WI 53226-3548
Phone (414) 955-8296

Other identifiers 1

IdentifierTypeStateIssuer
1215270616MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, AL2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20180612002512 WI Practitioner - Neurology 9931427820 Reassigns benefits to 1 organization
I20221219001396 AL Practitioner - Neurology 9931427820 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Indiana University School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Imc-Diagnostic and Medical Clinic LLCGroup PAC ID 2860399623, 168 clinicians

Practice addresses (Care Compare)

1720 Spring Hill Ave
Suite 300
Mobile, AL 36604-1410
Phone (251) 435-1200

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
45096ALMDVascular Neurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Imc-Diagnostic and Medical Clinic LLC Neurology CurrentSince Jan 1, 2023 Accepting new patients
Imc-Diagnostic and Medical Clinic LLC CurrentSince Jan 1, 2023 Accepting new patients
The Medical College of Wisconsin, Inc. CurrentSince May 1, 2018 Accepting new patients
Mobile Infirmary Association Past Accepting new patients

Locations

1700 Spring Hill Ave
Ste 100
Mobile, AL 36604

1720 Spring Hill Ave
Ste 300
Mobile, AL 36604
Phone 2514351200 ext. 1981

Bin 88350
Milwaukee, WI 53288
Phone (414) 805-3122

8701 Watertown Plank Rd
Wauwatosa, WI 53226
Phone (414) 456-4100

9200 W Wisconsin Ave
Wauwatosa, WI 53226
Phone (414) 259-3000

Interoperability endpoints

  • Direct secure messaging: csouthwood119077@directinfirmaryhealth.org

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

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

NPI Registry JSON

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

{
    "created_epoch": "1364947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673395200000",
    "number": "1215270616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 SPRING HILL AVE STE 100",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366041416",
            "telephone_number": "251-435-1200",
            "fax_number": "251-435-6357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1720 SPRING HILL AVE STE 300",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366041409",
            "telephone_number": "251-435-1200",
            "fax_number": "251-435-6357"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8701 W Watertown Plank Rd",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532263548",
            "country_code": "US",
            "telephone_number": "414-955-8296",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SOUTHWOOD",
        "first_name": "CHRISTOPHER",
        "middle_name": "JOHN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-03",
        "last_updated": "2023-01-11",
        "certification_date": "2023-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "WI",
            "license": "63355",
            "primary": false
        },
        {
            "code": "2084V0102X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Vascular Neurology",
            "state": "AL",
            "license": "45096",
            "primary": false
        },
        {
            "code": "2084A2900X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurocritical Care",
            "state": "AL",
            "license": "45096",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1215270616",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mobile, AL

Sources for this page

Verify at the official NPI Registry.