JAMES WILLIAM SOUTHAM (NPI# 1598301582) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598301582 |
| Entity Type | Individual |
| Full Name | JAMES WILLIAM SOUTHAM |
| Credential | NP-C, FNP |
| Practice Address |
1740 Nw Goetz St Roseburg OR 97471-1613 |
| Mailing Address |
1292 High St Ste 224 Eugene OR 97401-3238 |
| Practice Telephone | 5416407625 |
| Mailing Telephone | 5415002500 |
| Enumeration Date | 2019-11-25 |
| Last Update Date | 2020-01-24 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
201906644NP-PP | OR | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1740 NW GOETZ ST |
| City | ROSEBURG |
| State | OR |
| Zip Code | 97471-1613 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760473060 | Kerry Lyn Harrington | Emergency Medicine | 1740 Nw Goetz St, Roseburg, OR 97471-1613 | 2005-11-04 |
| 1851937924 | Thanita Pradhanang | Physician Assistant | 1740 Nw Goetz St, Roseburg, OR 97471-1613 | 2019-11-22 |
| 1467973826 | Jeffrey Samuel Ure | Physician Assistant | 1740 Nw Goetz St, Roseburg, OR 97471-1613 | 2017-07-06 |
| 1487185393 | April Marie Riverland | Physician Assistant | 1740 Nw Goetz St, Roseburg, OR 97471-1613 | 2017-03-22 |
| 1528498995 | Icco LLC | Clinic/Center | 1740 Nw Goetz St, Roseburg, OR 97471-1613 | 2013-11-20 |
| 1184060105 | Jessica Lynn Guido | Nurse Practitioner | 1740 Nw Goetz St, Roseburg, OR 97471-1613 | 2013-05-16 |
| 1689647927 | Matthew S. Driver | Emergency Medicine | 1740 Nw Goetz St, Roseburg, OR 97471-1613 | 2006-02-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841805660 | Rae Ann Barnes | Pharmacist | 913 Ne Garden Valley Blvd, Pharmacy, Roseburg, OR 97471 | 2020-09-09 |
| 1023651031 | Colton Phillips | Behavioral Analyst | 940 Nw Garden Valley Bvld #104, Roseburg, OR 97471 | 2019-10-22 |
| 1952884876 | Meredith Krugel Lcsw PC | Clinic/Center | 2225 Nw Stewart Parkway Ste 200, Roseburg, OR 97471 | 2018-09-07 |
| 1114456563 | Philip Kaser Family, LLC | Pharmacy | 1175 W. Harvard Avenue, Roseburg, OR 97471 | 2017-06-08 |
| 1053854208 | Icco LLC | Clinic/Center | 1740 Nw Goetz Street, Roseburg, OR 97471 | 2016-11-21 |
| 1770034589 | Evie Jepsen | Case Manager/Care Coordinator | 2700 Stewart Parkway Annex B, Suite 110, Roseburg, OR 97471 | 2016-10-17 |
| 1932551256 | Jonathan Schmidt | Licensed Practical Nurse | 913 Nm Garden Valley Blvd, Va Roseburg Medical Center, Roseburg, OR 97471 | 2016-07-11 |
| 1932580586 | Jeffrey Mark Wareham | Case Manager/Care Coordinator | 2700 Medical Loop, Annex B, Roseburg, OR 97471 | 2015-06-09 |
| 1558784215 | Ginger Jean Thibedeau | Massage Therapist | 3019 Nw Stewart Parkway, Suite 304 #183, Roseburg, OR 97471 | 2014-01-30 |
| 1427303122 | Karishma Parekh | Internal Medicine | 2460 Nw Stewart Pkwy Ste 103, Roseburg, OR 97471 | 2012-07-18 |
| Find all providers in zip 97471 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275194359 | Jennifer Ann Frost | Nurse Practitioner | 3369 Ne Stephens St # A, Roseburg, OR 97470-1200 | 2019-06-27 |
| 1730631375 | Alicia Denning Morrison | Nurse Practitioner | 2510 Nw Edenbower Blvd., Suite 152, Roseburg, OR 97471-8899 | 2016-10-31 |
| 1114337698 | Morgan Michelle Petersen | Nurse Practitioner | 427 W Carroll Ct, Roseburg, OR 97471-2368 | 2014-05-05 |
| 1689001000 | Forest Wayne Shira | Nurse Practitioner | 1863 Ne Freemont Ave, Roseburg, OR 97470-3535 | 2013-09-30 |
| 1700180098 | Rebekah Anna Syverson | Nurse Practitioner | 1318 Cattle Dr, Roseburg, OR 97470 | 2010-12-31 |
| 1609070531 | Wendy Zyzniewski | Nurse Practitioner | 201 Nw Medical Loop Ste 170, Roseburg, OR 97471-8835 | 2007-06-13 |
| 1588750228 | Eileen M Tabert | Nurse Practitioner | 544 W Umpqua St, Roseburg, OR 97470 | 2006-10-04 |
| 1093741449 | Mary E. Orians | Nurse Practitioner | 272 Nw Medical Loop Ste B, Roseburg, OR 97471-5545 | 2006-06-25 |
| 1255327151 | Janus Maybee | Nurse Practitioner | 1404 Se Mill St, Roseburg, OR 97470-4008 | 2005-09-26 |
| 1790243988 | Michelle Noelle Phelps | Nurse Practitioner | 1700 Nw Garden Valley Blvd Ste 201, Roseburg, OR 97471-1636 | 2019-03-06 |
| Find all providers in ROSEBURG | ||||
Please comment or provide details below to improve the information on JAMES WILLIAM SOUTHAM.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.