Individual provider Active NPI

Barbara Southerland, NURSE PRACTITIONER

  • Acute Care Nurse Practitioner
  • Philadelphia, PA
National Provider Identifier
1215600994
Registry record updated Jul 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
SP023117 Issued in PA
Practice address
100 E Lehigh Ave
Philadelphia, PA 19125-1012
Phone
(215) 707-1200
NPI assigned
Jul 28, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X SP023117 PA Primary

Addresses

Primary practice location

100 E Lehigh Ave
Philadelphia, PA 19125-1012

Mailing address

5727 Malvern Ave
Philadelphia, PA 19131-2219
Phone (267) 806-0185

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211221000069 PA Practitioner - Nurse Practitioner 0749671006 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellness Medical Services LLCGroup PAC ID 3971998717, 13 clinicians

Practice addresses (Care Compare)

1427 Horsham Rd
North Wales, PA 19454-1320
Phone (215) 277-7132

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
SP023117PAMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Temple Physicians Inc Current Accepting new patients
Temple Faculty Practice Plan Inc Current Accepting new patients
Temple Physician Inc. CurrentSince Sep 16, 2021 Accepting new patients
Temple Physicians Inc CurrentSince Sep 16, 2021 Accepting new patients
Temple Faculty Practice Plan Inc CurrentSince Sep 16, 2021 Accepting new patients
Wellness Medical Services LLC CurrentSince May 1, 2022 Accepting new patients
Wellness Medical SVCS PC CurrentSince Aug 11, 2024 Accepting new patients
Temple Faculty Practice Plan, Inc CurrentSince Sep 16, 2021 Accepting new patients

Locations

41 Newport Ave
Christiana, PA 17509
Phone (610) 593-6901

515 Pennsylvania Ave
Fl 2
Ft Washington, PA 19034
Phone (215) 540-0120

1427 Horsham Rd
North Wales, PA 19454
Phone (215) 277-7132

3401 N Broad St
Philadelphia, PA 19140
Phone (215) 707-3807

7600 Central Ave
Philadelphia, PA 19111
Phone (215) 707-5522

100 E Lehigh Ave
Philadelphia, PA 19125
Phone (215) 707-1200

Organizations & group practices 8

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": "1627430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627430400000",
    "number": "1215600994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5727 MALVERN AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191312219",
            "telephone_number": "267-806-0185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E LEHIGH AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191251012",
            "telephone_number": "215-707-1200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOUTHERLAND",
        "first_name": "BARBARA",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-28",
        "last_updated": "2021-07-28",
        "certification_date": "2021-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "PA",
            "license": "SP023117",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.