Individual provider Active NPI

Lucy C Southerland, M.D.

  • Anesthesiology Physician
  • Vancouver, WA
National Provider Identifier
1275520082
Registry record updated Apr 1, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
MD00041186 Issued in WA
Practice address
400 NE Mother Joseph PL
Vancouver, WA 98664-3200
Phone
(360) 256-2000
Fax
(360) 666-0466
NPI assigned
Oct 6, 2005
Last updated
Apr 1, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X WA
Anesthesiology Physician 207L00000X MD00041186 WA Primary

Addresses

Primary practice location

400 NE Mother Joseph PL
Vancouver, WA 98664-3200

Mailing address

PO Box 5157
Vancouver, WA 98668-5157
Phone (360) 667-3056

Other names 1

  • Lucy C McMillan Former name

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
Credentials
Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1128556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1238544000000",
    "number": "1275520082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5157",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986685157",
            "telephone_number": "360-667-3056",
            "fax_number": "360-666-0466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 NE MOTHER JOSEPH PL",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986643200",
            "telephone_number": "360-256-2000",
            "fax_number": "360-666-0466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOUTHERLAND",
        "first_name": "LUCY",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-06",
        "last_updated": "2009-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "WA",
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "WA",
            "license": "MD00041186",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LUCY",
            "last_name": "MCMILLAN",
            "middle_name": "C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Vancouver, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2009; 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.