Active NPI
Sara Southard
- Art Therapist
- Shepherdsville, KY
National Provider Identifier
1801099379
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Art Therapist
- License
- 0175
- Practice address
- 130 S Joe B Hall Ave
Shepherdsville, KY 40165-0690 - Phone
- (502) 589-8600
- Fax
- (502) 589-8771
- NPI assigned
- Jun 11, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | |||
| Art Therapist | 221700000X | 0175 | KY | Primary |
Addresses
Primary practice location
130 S Joe B Hall Ave
Shepherdsville, KY 40165-0690
Mailing address
101 W Muhammad Ali Blvd
Louisville, KY 40202-1423
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0175 | KY | MD | Art Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1181520000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1307577600000",
"number": "1801099379",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "101 W MUHAMMAD ALI BLVD",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402021423"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "130 S JOE B HALL AVE",
"city": "SHEPHERDSVILLE",
"state": "KY",
"postal_code": "401650690",
"telephone_number": "502-589-8600",
"fax_number": "502-589-8771"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SOUTHARD",
"first_name": "SARA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-06-11",
"last_updated": "2011-06-09",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": false
},
{
"code": "221700000X",
"taxonomy_group": "",
"desc": "Art Therapist",
"state": "KY",
"license": "0175",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Shepherdsville, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 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.