Individual provider Active NPI

Quyen C Soulsby, DPM

  • Foot Surgery Podiatrist
  • Wytheville, VA
National Provider Identifier
1245472364
Registry record updated Mar 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot Surgery PodiatristTaxonomy code 213ES0131X
License
0103301000 Issued in VA
Practice address
370 Loretto Dr
Wytheville, VA 24382-2078
Phone
(540) 588-1130
NPI assigned
Apr 3, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 0103301000 VA
Foot Surgery Podiatrist 213ES0131X 0103301000 VA Primary

Addresses

Primary practice location

370 Loretto Dr
Wytheville, VA 24382-2078

Mailing address

370 Loretto Dr
Wytheville, VA 24382-2078
Phone (540) 588-1130

Other identifiers 1

IdentifierTypeStateIssuer
9464361OtherVAAETNA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Soutwest Podiatry, P.C. Podiatrist PastSince Jun 15, 1998 Accepting new patients

Organizations & group practices 1

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": "1238716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362096000000",
    "number": "1245472364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "370 LORETTO DR",
            "city": "WYTHEVILLE",
            "state": "VA",
            "postal_code": "243822078",
            "telephone_number": "540-588-1130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "370 LORETTO DR",
            "city": "WYTHEVILLE",
            "state": "VA",
            "postal_code": "243822078",
            "telephone_number": "540-588-1130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOULSBY",
        "first_name": "QUYEN",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-03",
        "last_updated": "2013-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "VA",
            "license": "0103301000",
            "primary": false
        },
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "VA",
            "license": "0103301000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "9464361",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wytheville, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2013; 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.