Individual provider Active NPI

Michael J Southern, ARNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Garden City, KS
National Provider Identifier
1265622864
Registry record updated Jul 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
46076 Issued in KS
Practice address
302 Fleming St Ste 4
Garden City, KS 67846-6162
Phone
(620) 805-6939
Fax
(620) 805-6933
NPI assigned
Jul 30, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 46076 KS Primary

Addresses

Primary practice location

302 Fleming St Ste 4
Garden City, KS 67846-6162

Mailing address

302 Fleming St Ste 4
Garden City, KS 67846-6162
Phone (620) 805-6939

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
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
I20080202000015 KS Practitioner - Nurse Practitioner 6709968449 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Compass Behavioral HealthGroup PAC ID 1355323122, 29 clinicians

Practice addresses (Care Compare)

1111 E Spruce St
Garden City, KS 67846-5958
Phone (620) 276-7689

Hospital & facility affiliations

  • St. Catherine Hospital - Garden City Hospital, Garden City, KS, CCN 170023

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
46076KSMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Compass Behavioral Health CurrentSince Aug 22, 2007 Accepting new patients
Inspiring Change Counseling Services, LLC PastSince Jan 15, 2019 Accepting new patients
Compass Behavioral Health PastSince Jun 4, 2023 Accepting new patients

Locations

1111 E Spruce St
Garden City, KS 67846
Phone (620) 276-7689

Organizations & group practices 3

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.

Hospital & facility affiliations 1

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": "1185753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437436800000",
    "number": "1265622864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 FLEMING ST STE 4",
            "city": "GARDEN CITY",
            "state": "KS",
            "postal_code": "678466162",
            "telephone_number": "620-805-6939",
            "fax_number": "620-805-6933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 FLEMING ST STE 4",
            "city": "GARDEN CITY",
            "state": "KS",
            "postal_code": "678466162",
            "telephone_number": "620-805-6939",
            "fax_number": "620-805-6933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOUTHERN",
        "first_name": "MICHAEL",
        "middle_name": "J",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-30",
        "last_updated": "2015-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "KS",
            "license": "46076",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garden City, KS

Sources for this page

Verify at the official NPI Registry.