Jennifer Diane Southard, N.D.

Primary specialty

NaturopathTaxonomy code 175F00000X

License

099.0074287 Issued in VT

Practice address

105 S Riverside Dr
Suite 131
Indialantic, FL 32903-4365

Phone

(321) 409-0044

Fax

(321) 409-0099

NPI assigned

Jan 21, 2011

Last updated

Jan 21, 2011By the provider in NPPES

Sex

Female

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1295568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1295568000000",
    "number": "1356646343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 S RIVERSIDE DR",
            "address_2": "SUITE 131",
            "city": "INDIALANTIC",
            "state": "FL",
            "postal_code": "329034365",
            "telephone_number": "321-409-0044",
            "fax_number": "321-409-0099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 S RIVERSIDE DR",
            "address_2": "SUITE 131",
            "city": "INDIALANTIC",
            "state": "FL",
            "postal_code": "329034365",
            "telephone_number": "321-409-0044",
            "fax_number": "321-409-0099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOUTHARD",
        "first_name": "JENNIFER",
        "middle_name": "DIANE",
        "name_prefix": "Dr.",
        "credential": "N.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-01-21",
        "last_updated": "2011-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175F00000X",
            "taxonomy_group": "",
            "desc": "Naturopath",
            "state": "VT",
            "license": "099.0074287",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Skilled Physicians Inc
• Debra Jill Sloane, PSYD
• Glenn Sloman, PH.D., BCBA-D, NSCP
• Keith Barry Smith, OPTICIAN
• Ginger Diane Snead, DPT
• Haya Soya, PSY,D.
• Douglas Arthur St Clair, M.D.
• Starfish Collaborative Care, LLC
• James E Steele, D.O.
• Wayne S Stein, PSY.D.

• Naturopath in Indialantic, FL
• Providers in Indialantic, FL by specialty
• Naturopath in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2011; 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.