Organization Active NPI

Scott W Southard MD Inc

  • Orthopaedic Surgery Physician
  • Gardnerville, NV
National Provider Identifier
1811136161
Registry record updated Jan 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
6292 Issued in NV
Legal business name
SCOTT W SOUTHARD MD INC
Practice address
1520 Virginia Ranch Rd Ste 1B
Gardnerville, NV 89410-5732
Phone
(530) 541-4119
Fax
(530) 541-3246
NPI assigned
Feb 10, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2019

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

Authorized official

Name
Kathy Barela
Title
Office Manager
Phone
(530) 541-4119

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207X00000X 6292 NV Primary
Orthopaedic Surgery PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207X00000X G60029 CA

Addresses

Primary practice location

1520 Virginia Ranch Rd Ste 1B
Gardnerville, NV 89410-5732

Mailing address

1520 Virginia Ranch Rd Ste 1B
Gardnerville, NV 89410-5732
Phone (530) 541-4119

Other identifiers 1

IdentifierTypeStateIssuer
002003053MedicaidNV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090727000382 NV Part B Supplier - Clinic/Group Practice 4183777980 Receives reassigned benefits from 2 practitioners
Practice locations: Gardnerville, NV

National Provider Directory

National Provider Directory

Locations

1520 Virginia Ranch Rd
Ste 1B
Gardnerville, NV 89410
Phone (775) 782-1670

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1234224000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1547683200000",
    "number": "1811136161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1520 VIRGINIA RANCH RD STE 1B",
            "city": "GARDNERVILLE",
            "state": "NV",
            "postal_code": "894105732",
            "telephone_number": "530-541-4119",
            "fax_number": "530-541-3246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1520 VIRGINIA RANCH RD STE 1B",
            "city": "GARDNERVILLE",
            "state": "NV",
            "postal_code": "894105732",
            "telephone_number": "530-541-4119",
            "fax_number": "530-541-3246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SCOTT W SOUTHARD MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-10",
        "last_updated": "2019-01-17",
        "status": "A",
        "authorized_official_last_name": "BARELA",
        "authorized_official_first_name": "KATHY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "530-541-4119"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "NV",
            "license": "6292",
            "primary": true
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "CA",
            "license": "G60029",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002003053",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gardnerville, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.