Mikle South, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

6841090-2501 Issued in UT

Practice address

1551 Shoup CT
Decatur, GA 30033-4607

Phone

(404) 727-8350

NPI assigned

Oct 2, 2012

Sex

Male

Sole proprietor

Yes

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 GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Merit-based Incentive Payment System (MIPS)

Final score

94.51 of 100Reported as apm

Quality

80.61

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• The Emory Clinic Inc

  • Internal Medicine Physician
  • Atlanta, GA
  • NPI 1396798229

  GA

  Medicare reassignment NPD
• Eac Services LLC

  • Developmental Disabilities Clinic/Center
  • Decatur, GA
  • NPI 1639633050
  NPD (past)

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

{
    "created_epoch": "1349136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645401600000",
    "number": "1306198262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1551 SHOUP CT",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300334607",
            "telephone_number": "404-727-8350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1551 SHOUP CT",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300334607",
            "telephone_number": "404-727-8350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOUTH",
        "first_name": "MIKLE",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-10-02",
        "last_updated": "2022-02-21",
        "certification_date": "2022-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "UT",
            "license": "6841090-2501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• South Dekalb Family Physicians, LLC
• South Dekalb Pediatrics, P.C.
• South Dekalb Primary Care, PC
• South Dekalb Spinal Center, LLC
• Ashley Michelle South, OTR/L
• Southeastern Orthopedic Surgical PA, LLC
• Southern Healthcare Provider Group, LLC
• Southern Ocular Prosthetics, LLC
• Southern Women'S Housing Alliance, Inc
• Southside Medical Center, Inc

• All providers in Decatur, GA
• Clinical Psychologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.