Southern Obstetric & Gyneco Associates

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

042005236 Issued in IL

Legal business name

SOUTHERN OBSTETRIC & GYNECO ASSOCIATES

Doing business as

Southern OB/GYN-Highland

Practice address

1328 Mercantile Dr
Highland, IL 62249-1257

Phone

(618) 654-4836

Fax

(618) 526-7372

NPI assigned

Apr 28, 2011

Organization subpart

No

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

Authorized official

Name

Anne Doll-Pollard, M.D.NPI 1881652626

Title

President

Phone

(618) 526-2209

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Southern OB/GYN-Highland Doing business as

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Southern Obstetric & Gyneco Associates

  dba Southern OB/GYN

  • Obstetrics & Gynecology Physician
  • Greenville, IL
  • NPI 1205199452

  O20041130000387

  Same enrollment
• Southern Obstetric & Gyneco Associates

  dba Southern OB/GYN

  • Obstetrics & Gynecology Physician
  • Breese, IL
  • NPI 1467419804

  O20041130000387

  Same enrollment
• Southern Obstetric & Gyneco Associates

  dba Southern OB/GYN

  • Obstetrics & Gynecology Physician
  • Salem, IL
  • NPI 1881958981

  O20041130000387

  Same enrollment

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Anne Doll-Pollard, M.D.

  • Obstetrics & Gynecology Physician
  • Breese, IL
  • NPI 1881652626
  Authorized official Same address or phone
• Megan Lynn Koehler, CNM

  • Advanced Practice Midwife
  • Breese, IL
  • NPI 1669986121
  NPD

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

{
    "created_epoch": "1303948800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1303948800000",
    "number": "1962793687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9447 HOLY CROSS LN",
            "city": "BREESE",
            "state": "IL",
            "postal_code": "622303510",
            "telephone_number": "618-526-2209",
            "fax_number": "618-526-7372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1328 MERCANTILE DR",
            "city": "HIGHLAND",
            "state": "IL",
            "postal_code": "622491257",
            "telephone_number": "618-654-4836",
            "fax_number": "618-526-7372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN OBSTETRIC & GYNECO ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-28",
        "last_updated": "2011-04-28",
        "status": "A",
        "authorized_official_last_name": "DOLL-POLLARD",
        "authorized_official_first_name": "ANNE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "618-526-2209",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "IL",
            "license": "042005236",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CORPORATE LICENSE",
            "identifier": "042005236",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southern OB/GYN-Highland",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Chelsey Rachelle Short, M.S. CCC-SLP
• Emalee Shubert
• Donald E. Smith, CRNA
• Lauren Virginia Smith, PNP
• Southern Illinois Gastroenterology LLC
• St Josephs Hospital Breese of the Hospital Sisters of the Third Orde (Madison County Rural Health)
• St Josephs Hospital of the Hospital Sisters of the Third Order of St F
• St Josephs Hospital of the Hospital Sisters of the Third Order of St F
• St Josephs Hospital of the Hospital Sisters of the Third Order of St F (HSHS St. Joseph's Hospital -Highland)
• St Josephs Hospital of the Hospital Sisters of the Third Order of St F

• Obstetrics & Gynecology Physician in Highland, IL
• Providers in Highland, IL by specialty
• Obstetrics & Gynecology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2011; 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.