Austin Southmayd, PA-C MLS

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

2022043266 Issued in MO

Practice address

615 S New Ballas Rd
Saint Louis, MO 63141-8221

Phone

(314) 251-6000

NPI assigned

Nov 1, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

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

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Mercy Clinic Adult Hospitalists - St. Louis, LLC

  • Internal Medicine Physician
  • Saint Louis, MO
  • NPI 1841235108
  Medicare reassignment

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

{
    "created_epoch": "1667260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667260800000",
    "number": "1275240152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 PRAIRIE MEADOW CT",
            "city": "SAINT PETERS",
            "state": "MO",
            "postal_code": "633047713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 S NEW BALLAS RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418221",
            "telephone_number": "314-251-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOUTHMAYD",
        "first_name": "AUSTIN",
        "credential": "PA-C MLS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-11-01",
        "last_updated": "2022-11-01",
        "certification_date": "2022-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MO",
            "license": "2022043266",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristopher Southard
• Richard Southard, MD
• Southern Home Care Services, Inc
• Southern Home Care Services, Inc.
• Southerncare Inc
• Southside Dental Care, L.L.C.
• Southside Medical Group PC
• Southside Wellness Center Inc
• Southwest Endodontic Assoc.
• Southwest Endodontics

• Physician Assistant in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Physician Assistant in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.