Rose S Southerland, DPM

Primary specialty

Primary Podiatric Medicine PodiatristTaxonomy code 213EP1101X

License

520 Issued in NC

Practice address

1202 Medical Center Dr
Wilmington, NC 28401-7307

Phone

(910) 341-3300

Fax

(910) 251-2067

NPI assigned

Feb 4, 2007

Last updated

Mar 23, 2018By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

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

Specialty

Podiatry

Education

Kent State University College of Podiatric Medicine, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Wilmington Health PLLCGroup PAC ID 6103722509, 364 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: rose.southerland.p1@direct.wilmingtonhealth.nextgenshare.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Wilmington Health PLLC

  • Multi-Specialty Clinic/Center
  • Wilmington, NC
  • NPI 1881632339
  Medicare reassignment Care Compare group NPD
• South Coast Foot and Ankle Inc

  • Foot & Ankle Surgery Podiatrist
  • Ocean Isle Beach, NC
  • NPI 1720356942
  Authorized official Same address or phone
• Wilmington ASC LLC

  dba Wilmington Health Ambulatory Surgery Center

  • Ambulatory Surgical Clinic/Center
  • Wilmington, NC
  • NPI 1548456478
  NPD
• Wilmington Health PLLC

  • Sleep Specialist (PhD)
  • Wilmington, NC
  • NPI 1043485097
  NPD
• Palmetto Podiatry Group of Anderson, PA

  • Podiatrist
  • Rock Hill, SC
  • NPI 1336181668

  Primary Podiatric Medicine

  NPD (past)

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

{
    "created_epoch": "1170547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521763200000",
    "number": "1790823334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 UNION SCHOOL RD NW STE 1",
            "city": "OCEAN ISLE BEACH",
            "state": "NC",
            "postal_code": "284697307",
            "telephone_number": "910-579-0828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1202 MEDICAL CENTER DR",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284017307",
            "telephone_number": "910-341-3300",
            "fax_number": "910-251-2067"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "25 Union School Rd NW Ste 1",
            "address_purpose": "LOCATION",
            "city": "Ocean Isle Beach",
            "state": "NC",
            "postal_code": "284697307",
            "country_code": "US",
            "telephone_number": "910-579-0828",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SOUTHERLAND",
        "first_name": "ROSE",
        "middle_name": "S",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-04",
        "last_updated": "2018-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NC",
            "license": "520",
            "primary": false
        },
        {
            "code": "213EP1101X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "NC",
            "license": "520",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Southeastern Healthcare Centers PC
• Southeastern Healthcare of Monkey Junction PC (Southeastern Healthcare Of Monkey Junction)
• Southeastern Medical Group, P.a.
• Southeastern Nephrology Associates, PLLC
• Southeastern United Care LLC
• Southern Cross Commuinty Services Inc (Southern Cross Mental Health Centers)
• Southern Cross Community Services, Inc (Southern Cross Mental Health Centers)
• Southern Cross Community Services, Inc (Southern Cross Mental Health Centers)
• Southside Medical Center PA
• Southside Medical Center, PA

• Primary Podiatric Medicine Podiatrist in Wilmington, NC
• Providers in Wilmington, NC by specialty
• Primary Podiatric Medicine Podiatrist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2018; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.