Southerncare, Inc.

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

License

2016 Issued in WI

Legal business name

SOUTHERNCARE, INC.

Practice address

1800 W Mason St Ste a
Green Bay, WI 54303-2333

Phone

(920) 496-1690

Fax

(920) 496-1693

NPI assigned

Jun 6, 2006

Organization subpart

No

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

Authorized official

Name

Jessica Kleberg

Title

VP of Legal Affairs

Phone

(704) 664-2876

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• SouthernCare Green Bay Doing business as

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Curo Health Services, LLC

  • Community Based Hospice Care Agency
  • Fairfax, VA
  • NPI 1447959762

  Member Of

  NPD member

Locations

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

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1510531200000",
    "number": "1992744775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "655 BRAWLEY SCHOOL RD",
            "address_2": "SUITE 200",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281179125",
            "telephone_number": "704-664-2876",
            "fax_number": "704-664-1306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 W MASON ST STE A",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543032333",
            "telephone_number": "920-496-1690",
            "fax_number": "920-496-1693"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERNCARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-06",
        "last_updated": "2017-11-13",
        "status": "A",
        "authorized_official_last_name": "KLEBERG",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "VP OF LEGAL AFFAIRS",
        "authorized_official_telephone_number": "704-664-2876"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "WI",
            "license": "2016",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "2016",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43191100",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SouthernCare Green Bay",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Brea A Sorge, APNP
• Christopher C Sorrells, MD
• David Alan Sorrentino, D.O.
• Courtney Wagner Souheaver, DPT
• Nathan Souheaver, DPT
• Robert David Southwick, MD
• Jennifer April Sovey Fahey, BS MSW LCSW
• Courtney S Sowers, LPC
• Space Coast Family Practice
• Nicole Lee Spaeth, APNP

• Community Based Hospice Care Agency in Green Bay, WI
• Providers in Green Bay, WI by specialty
• Community Based Hospice Care Agency in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2017; 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.