Robert Charles Southmayd, D.O.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

5298 Issued in CA

Practice address

1768 Mitchell Rd Ste 301
Ceres, CA 95307-2156

Phone

(209) 353-4838

NPI assigned

Sep 16, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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

• San Joaquin Behavioral Health Services

  • Community/Behavioral Health Agency
  • Stockton, CA
  • NPI 1215028931
  Medicare reassignment NPD
• Aegis Treatment Centers, LLC

  • Methadone Clinic
  • Ceres, CA
  • NPI 1932759289
  NPD
• County of San Joaquin

  • Multi-Specialty Clinic/Center
  • Manteca, CA
  • NPI 1417407636
  NPD
• Aegis Treatment Centers, LLC

  • Methadone Clinic
  • Banning, CA
  • NPI 1376293407
  NPD (past)

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

{
    "created_epoch": "1158364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761091200000",
    "number": "1982700969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3062 JOSHUA TREE CIR",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952093800",
            "telephone_number": "209-244-8101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1768 MITCHELL RD STE 301",
            "city": "CERES",
            "state": "CA",
            "postal_code": "953072156",
            "telephone_number": "209-353-4838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOUTHMAYD",
        "first_name": "ROBERT",
        "middle_name": "CHARLES",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-16",
        "last_updated": "2025-10-22",
        "certification_date": "2025-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "5298",
            "primary": true
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "20A5298",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "911803606",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00AX52980",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "160038160",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marie Soriano
• Amanda Christine Sorrels
• Jaime Soto Jr.
• Jeremy Soto
• Rosa A Soto, LMFT
• Harvey A Soza Jr.
• Alysa Maren Sparkman-Mendoza
• Stanislaus County
• Stanislaus County BHRS
• Stanislaus County BHRS

• Internal Medicine Physician in Ceres, CA
• Providers in Ceres, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2025; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.