Individual provider Active NPI

Joe Taltson Southerland, DPM

  • Foot & Ankle Surgery Podiatrist
  • Jasper, GA
National Provider Identifier
1659321107
Registry record updated Feb 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
POD000709 Issued in GA
Practice address
49 Gordon Rd
Suite 104
Jasper, GA 30143
Phone
(770) 999-0804
Fax
(770) 999-0814
NPI assigned
May 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 1473 TX
Foot & Ankle Surgery Podiatrist 213ES0103X POD000709 GA Primary

Addresses

Primary practice location

49 Gordon Rd
Suite 104
Jasper, GA 30143

Mailing address

400 W Arbrook Blvd
Suite 201
Arlington, TX 76014-3174
Phone (817) 467-1990

Other identifiers 1

IdentifierTypeStateIssuer
8F8971OtherTXBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240510002079 GA Practitioner - Podiatry 7719915123 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Barry University School of Podiatric Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Foot and Ankle Reconstruction of Georgia PCGroup PAC ID 4981072147, 3 clinicians

Practice addresses (Care Compare)

3225 Shallowford Rd
Suite 200
Marietta, GA 30062-1288
Phone (770) 999-0804

Hospital & facility affiliations

  • Northside Hospital Cherokee Hospital, Canton, GA, CCN 110008

Merit-based Incentive Payment System (MIPS)

Final score
70.97 of 100Reported as group
Quality
43.69
Promoting interoperability
91
Improvement activities
40
Cost
67.06

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue39
Removal of skin lesions12
Removal of nail tissue477
Removal or shaving of skin growth235

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1473TXMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Arlington Surgicare Partners, LTD PastSince Oct 1, 2001 Accepting new patients

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739836800000",
    "number": "1659321107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 W ARBROOK BLVD",
            "address_2": "SUITE 201",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760143174",
            "telephone_number": "817-467-1990",
            "fax_number": "817-466-8737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "49 GORDON RD",
            "address_2": "SUITE 104",
            "city": "JASPER",
            "state": "GA",
            "postal_code": "30143",
            "telephone_number": "770-999-0804",
            "fax_number": "770-999-0814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOUTHERLAND",
        "first_name": "JOE",
        "middle_name": "TALTSON",
        "name_prefix": "Mr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-12",
        "last_updated": "2025-02-18",
        "certification_date": "2025-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "TX",
            "license": "1473",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "GA",
            "license": "POD000709",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8F8971",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jasper, GA

Sources for this page

Verify at the official NPI Registry.