Southern Nurses Inc.

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

SOUTHERN NURSES INC.

Doing business as

Lakeside Lodge Assisted Living
Southern Nurses Wound Care

Practice address

254 Parkside Loop
Brookeland, TX 75931-6247

Phone

(409) 698-3800

NPI assigned

Mar 2, 2019

Organization subpart

No

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

Authorized official

Name

Mrs. Vicky M. St. John, APN-CNPI 1033580394

Title

Ceo

Phone

(409) 460-0603

Specialties & licenses 1

Addresses

Other names 2

• Lakeside Lodge Assisted Living Doing business as
• Southern Nurses Wound Care Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Vicky St John, APRN

  • Family Nurse Practitioner
  • Jasper, TX
  • NPI 1033580394
  NPD Authorized official

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

{
    "created_epoch": "1551484800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1551484800000",
    "number": "1598223141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13054 US HIGHWAY 96 S",
            "city": "KIRBYVILLE",
            "state": "TX",
            "postal_code": "759564549",
            "telephone_number": "409-460-0603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "254 PARKSIDE LOOP",
            "city": "BROOKELAND",
            "state": "TX",
            "postal_code": "759316247",
            "telephone_number": "409-698-3800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN NURSES INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-02",
        "last_updated": "2019-03-02",
        "status": "A",
        "authorized_official_last_name": "ST. JOHN",
        "authorized_official_first_name": "VICKY",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "409-460-0603",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "APN-C"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lakeside Lodge Assisted Living",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Southern Nurses Wound Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jasper Dental Emporium
• Jasper Hospital District
• Melanie Denise Kellam, PHD
• Monte O'Neal, DO
• John Joshua Seale, DDS
• Vivian Elaine Toland, LCSW

• Assisted Living Facility in Brookeland, TX
• Providers in Brookeland, TX by specialty
• Assisted Living Facility in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2019; 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.