Michelle Martin Southard, DO

Primary specialty

Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X

License

P4783 Issued in TX

Practice address

800 8TH Ave Ste 116
Fort Worth, TX 76104-2606

Phone

(817) 335-6363

NPI assigned

Feb 26, 2013

Last updated

Jun 21, 2023By 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 4

Addresses

Other names 1

• Dr. Abbe Michelle Martin Former name

Medicare fee-for-service enrollment

Enrolled in TX

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

Specialty

Plastic and Reconstructive Surgery

Education

Edward Via Col of Osteo Medicine-Virginia Campus, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Baylor Scott and White All Saints Medical Center Hospital, Fort Worth, TX, CCN 450137
• Texas Health Harris Methodist Fort Worth Hospital, Fort Worth, TX, CCN 450135

Procedures performed for Medicare patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Resilient Plastic Surgery, PLLC

  • Plastic and Reconstructive Surgery Physician
  • Fort Worth, TX
  • NPI 1932807682

  Plastic Surgery

  Medicare reassignment NPD Authorized official

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Baylor All Saints Medical Center

  dba Baylor Scott & White All Saints Medical Center - Fort Worth

  • General Acute Care Hospital
  • Fort Worth, TX
  • NPI 1669472387
  Care Compare affiliation
• Texas Health Harris Methodist Hospital Fort Worth

  • General Acute Care Hospital
  • Fort Worth, TX
  • NPI 1336172105
  Care Compare affiliation

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

{
    "created_epoch": "1361836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687305600000",
    "number": "1992045090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 8TH AVE STE 116",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761042606",
            "telephone_number": "817-335-6363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 8TH AVE STE 116",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761042606",
            "telephone_number": "817-335-6363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOUTHARD",
        "first_name": "MICHELLE",
        "middle_name": "MARTIN",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-02-26",
        "last_updated": "2023-06-21",
        "certification_date": "2023-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "MI",
            "license": "5101020787",
            "primary": false
        },
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "TX",
            "license": "P4783",
            "primary": false
        },
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "MI",
            "license": "5101020787",
            "primary": false
        },
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "TX",
            "license": "P4783",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ABBE",
            "last_name": "MARTIN",
            "middle_name": "MICHELLE",
            "prefix": "DR.",
            "credential": "DO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• South Texas Dental Associates, L.P.
• South Texas Dental Associates, L.P.
• South Texas Dental Associates, LP
• South Texas Dental Associates, LP
• Mika Southall, SLP
• Chelsey Southern, PA-C
• Southerncare Inc (SouthernCare Ft Worth)
• Southlake Dental Corp
• Southlake Neuromonitoring LLC
• Southlake Orthopedics & Sports Medicine, PLLC (Summit Orthopedics of Texas)

• Plastic and Reconstructive Surgery Physician in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Plastic and Reconstructive Surgery Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.