Cathleen Helena Southall, ARNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

ARNP9232015 Issued in FL

Practice address

2606 Park St
Jacksonville, FL 32204-4520

Phone

(904) 388-4646

Fax

(904) 388-9017

NPI assigned

Apr 19, 2010

Last updated

Apr 22, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: cathleen.southall.1@8042.direct.athenahealth.com

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

{
    "created_epoch": "1271635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619049600000",
    "number": "1821314683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 S FISKE BLVD",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "329554306",
            "telephone_number": "904-388-4646",
            "fax_number": "904-388-9017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2606 PARK ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322044520",
            "telephone_number": "904-388-4646",
            "fax_number": "904-388-9017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOUTHALL",
        "first_name": "CATHLEEN",
        "middle_name": "HELENA",
        "name_prefix": "Mrs.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-19",
        "last_updated": "2021-04-22",
        "certification_date": "2021-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "FL",
            "license": "ARNP9232015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• South Mandarin Chiropractic & Wellness
• South Mandarin Chiropractic and Wellness, Inc.
• South Rehabilitation Center, Inc.
• Catherine Nicole South
• Matthew Travis South
• Southbrdge Health and Wellness LLC
• Southeast Anesthesia Consultants, LLC
• Southeast Gynecologic Oncology Associates PA
• Southeast Orthopedic Specialists, Inc
• Southeast Orthopedic Specialists, Inc

• Pediatric Nurse Practitioner in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Pediatric Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2021; 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.