Active NPI
Lucy C Southerland, M.D.
- Anesthesiology Physician
- Vancouver, WA
National Provider Identifier
1275520082
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- MD00041186
- 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, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
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"
}
]
}
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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.