Individual provider Active NPI

Scott Jeffrey Southard, RPH

  • Pharmacist
  • The Villages, FL
National Provider Identifier
1346412475
Registry record updated Jan 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PS64186 Issued in FL
Practice address
400 Colony Blvd
The Villages, FL 32162-6086
Phone
(315) 622-4000
Fax
(585) 622-0250
NPI assigned
Mar 28, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 048172 NY
Pharmacist 183500000X PS64186 FL Primary

Addresses

Primary practice location

400 Colony Blvd
The Villages, FL 32162-6086

Mailing address

400 Colony Blvd
The Villages, FL 32162-6086
Phone (352) 205-7010

Other identifiers 2

IdentifierTypeStateIssuer
PS64186OtherFLPHARMACIST LICENSE
048172OtherNYPHARMACIST LICENSE

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)
Not enrolled
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
PS64186FLMDPharmacist
048172NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co CurrentSince Jan 8, 2023 Accepting new patients
Walgreen Co PastSince Jan 8, 2023 Accepting new patients
Wegmans Food Markets, Inc. Past Accepting new patients
Wegmans Food Markets, Inc. Past Accepting new patients

Locations

400 Colony Blvd
The Villages, FL 32162
Phone (352) 205-7010

Organizations & group practices 4

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": "1206662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672617600000",
    "number": "1346412475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 COLONY BLVD",
            "city": "THE VILLAGES",
            "state": "FL",
            "postal_code": "321626086",
            "telephone_number": "352-205-7010",
            "fax_number": "352-205-8951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 COLONY BLVD",
            "city": "THE VILLAGES",
            "state": "FL",
            "postal_code": "321626086",
            "telephone_number": "315-622-4000",
            "fax_number": "585-622-0250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOUTHARD",
        "first_name": "SCOTT",
        "middle_name": "JEFFREY",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-03-28",
        "last_updated": "2023-01-02",
        "certification_date": "2023-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "048172",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS64186",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACIST LICENSE",
            "identifier": "PS64186",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACIST LICENSE",
            "identifier": "048172",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in The Villages, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.