Active NPI
Lauren Pulliam Southern, PT, DPT
- Physical Therapist
- High Point, NC
National Provider Identifier
1285227751
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- P20085
- Practice address
- 4515 Premier Dr Ste 307a
High Point, NC 27265-8356 - Phone
- (336) 802-2685
- NPI assigned
- Feb 16, 2021
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | P20085 | NC | Primary |
Addresses
Primary practice location
4515 Premier Dr Ste 307a
High Point, NC 27265-8356
Mailing address
4515 Premier Dr Ste 307a
High Point, NC 27265-8356
Phone (336) 802-2685
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1613433600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1622937600000",
"number": "1285227751",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4515 PREMIER DR STE 307A",
"city": "HIGH POINT",
"state": "NC",
"postal_code": "272658356",
"telephone_number": "336-802-2685"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4515 PREMIER DR STE 307A",
"city": "HIGH POINT",
"state": "NC",
"postal_code": "272658356",
"telephone_number": "336-802-2685"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SOUTHERN",
"first_name": "LAUREN",
"middle_name": "PULLIAM",
"credential": "PT, DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-02-16",
"last_updated": "2021-06-06",
"certification_date": "2021-06-06",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NC",
"license": "P20085",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in High Point, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.