Individual provider Active NPI

Stephen E Southard Jr., M.D.

  • Internal Medicine Physician
  • Erie, CO
National Provider Identifier
1316074776
Registry record updated Aug 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
CDRH.0061297 Issued in CO
Practice address
1160 Hickory Way
Erie, CO 80516-7994
Phone
(617) 840-8445
Fax
(617) 789-9549
NPI assigned
Feb 27, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 27, 2025

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

Specialties & licenses 15

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X L-228504 MA
Internal Medicine Physician 207R00000X 38056 AL
Internal Medicine Physician 207R00000X 18759 NV
Internal Medicine Physician 207R00000X 59425 TN
Internal Medicine Physician 207R00000X 11224295-1205 UT
Internal Medicine Physician 207R00000X C197633 CA
Internal Medicine Physician 207R00000X 01094663A IN
Internal Medicine Physician 207R00000X 102003 GA
Internal Medicine Physician 207R00000X 2024036775 MO
Internal Medicine Physician 207R00000X 2024-02849 NC
Internal Medicine Physician 207R00000X V5609 TX
Medical Specialty Clinic/Center 261QM2500X 1043889967 NY
Medical Specialty Clinic/Center 261QM2500X 1992372403 CT
Medical Specialty Clinic/Center 261QM2500X 1992372403 NJ
Internal Medicine Physician 207R00000X CDRH.0061297 CO Primary

Addresses

Primary practice location

1160 Hickory Way
Erie, CO 80516-7994

Mailing address

1160 Hickory Way
Erie, CO 80516-7994
Phone (617) 840-8445

Other practice location 1

1800 Phoenix Blvd Ste 128-12
Atlanta, GA 30349-5593
Phone (844) 359-8363

Other practice location 2

3065 Brighton 2nd St # 1014
Brooklyn, NY 11235-7404
Phone (844) 359-8363

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, AL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20090808000091 MA Practitioner - Internal Medicine 1355494303 Reassigns benefits to 1 organization
I20210923002690 AL Practitioner - Internal Medicine 1355494303 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
18759NVMDPharmacist
C197633CAMDInternal Medicine Physician
102003GAMDInternal Medicine Physician
01094663AINMDInternal Medicine Physician
L-228504MAMDInternal Medicine Physician
2024036775MOMDInternal Medicine Physician
2024-02849NCMDInternal Medicine Physician
59425TNMDInternal Medicine Physician
V5609TXMDInternal Medicine Physician
11224295-1205UTMDInternal Medicine Physician
1992372403CTMDMedical Specialty Clinic/Center
1992372403NJMDMedical Specialty Clinic/Center
1043889967NYMDMedical Specialty Clinic/Center

Practice roles

OrganizationSpecialtyStatusNew patients
Wellesley Primary Care Medicine, PC CurrentSince Oct 8, 2013 Accepting new patients
Healthtap Medical Group, P.C. CurrentSince Jul 26, 2021 Accepting new patients

Locations

641 S Lawrence St
Montgomery, AL 36104
Phone (800) 221-5140

2465 Latham St
Ste 300
Mountain View, CA 94040
Phone (650) 268-9806

Dept LA 25281
Pasadena, CA 91185

1900 W Littleton Blvd
Littleton, CO 80120
Phone 41550438389238

65 Walnut St
Ste 500
Wellesley Hills, MA 02481
Phone (781) 431-2345

Interoperability endpoints

  • Direct secure messaging: stephen.southard.1@25522.direct.athenahealth.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756252800000",
    "number": "1316074776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1160 HICKORY WAY",
            "city": "ERIE",
            "state": "CO",
            "postal_code": "805167994",
            "telephone_number": "617-840-8445",
            "fax_number": "617-789-9549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1160 HICKORY WAY",
            "city": "ERIE",
            "state": "CO",
            "postal_code": "805167994",
            "telephone_number": "617-840-8445",
            "fax_number": "617-789-9549"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1800 Phoenix Blvd Ste 128-12",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303495593",
            "country_code": "US",
            "telephone_number": "844-359-8363",
            "fax_number": "833-929-3520",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3065 Brighton 2nd St # 1014",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112357404",
            "country_code": "US",
            "telephone_number": "844-359-8363",
            "fax_number": "833-955-3592",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SOUTHARD",
        "first_name": "STEPHEN",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-27",
        "last_updated": "2025-08-27",
        "certification_date": "2025-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "L-228504",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AL",
            "license": "38056",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NV",
            "license": "18759",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "59425",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "UT",
            "license": "11224295-1205",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "C197633",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "01094663A",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "102003",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "2024036775",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "2024-02849",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "V5609",
            "primary": false
        },
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "NY",
            "license": "1043889967",
            "primary": false
        },
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "CT",
            "license": "1992372403",
            "primary": false
        },
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "NJ",
            "license": "1992372403",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CO",
            "license": "CDRH.0061297",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Erie, CO

Sources for this page

Verify at the official NPI Registry.