Active NPI
Stephen E Southard Jr., M.D.
- Internal Medicine Physician
- Erie, CO
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- CDRH.0061297
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 15
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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, AL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18759 | NV | MD | Pharmacist |
| C197633 | CA | MD | Internal Medicine Physician |
| 102003 | GA | MD | Internal Medicine Physician |
| 01094663A | IN | MD | Internal Medicine Physician |
| L-228504 | MA | MD | Internal Medicine Physician |
| 2024036775 | MO | MD | Internal Medicine Physician |
| 2024-02849 | NC | MD | Internal Medicine Physician |
| 59425 | TN | MD | Internal Medicine Physician |
| V5609 | TX | MD | Internal Medicine Physician |
| 11224295-1205 | UT | MD | Internal Medicine Physician |
| 1992372403 | CT | MD | Medical Specialty Clinic/Center |
| 1992372403 | NJ | MD | Medical Specialty Clinic/Center |
| 1043889967 | NY | MD | Medical Specialty Clinic/Center |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wellesley Primary Care Medicine, PC | Current | Accepting new patients | |
| Healthtap Medical Group, P.C. | Current | 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
- 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.
-
- General Practice Physician
- Wellesley, MA
- NPI 1750502795
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2025; 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.