Colton Southard-Goebel, MD

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

MMD.92656 Issued in SC

Practice address

169 Ashley Avenue Room 202 Main Hospital
Msc333
Charleston, SC 29425

Phone

(843) 792-1932

NPI assigned

Mar 28, 2023

Last updated

Jul 23, 2024By the provider in NPPES

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 SC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1679961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721692800000",
    "number": "1285338954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "169 ASHLEY AVE RM 202",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294258905",
            "telephone_number": "843-792-1932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "169 ASHLEY AVENUE ROOM 202 MAIN HOSPITAL",
            "address_2": "MSC333",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "29425",
            "telephone_number": "843-792-1932"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOUTHARD-GOEBEL",
        "first_name": "COLTON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-03-28",
        "last_updated": "2024-07-23",
        "certification_date": "2024-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "SC",
            "license": "MMD.92656",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• South Carolina Medical Specialists PC
• South Carolina Mentor
• South Carolina Neuro, LLC
• South Carolina Women's Center, LLC
• Roger A Southall, Jr, CRNA
• Bailey Southard, PHARMD
• Kinsey Knight Southard, PA-C
• Molly Mae Southard, RN
• Southeast Cardiology
• Southeast Endodontics, PC

• Anesthesiology Physician in Charleston, SC
• Providers in Charleston, SC by specialty
• Anesthesiology Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2024; 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.