ROSE S SOUTHERLAND (NPI# 1790823334) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1790823334 |
Entity Type | Individual |
Full Name | ROSE S SOUTHERLAND |
Credential | DPM |
Practice Address |
1202 Medical Center Dr Wilmington NC 28401-7307 |
Mailing Address |
25 Union School Rd Nw Ste 1 Ocean Isle Beach NC 28469-7307 |
Practice Telephone | 9103413300 |
Practice Fax Number | 9102512067 |
Mailing Telephone | 9105790828 |
Enumeration Date | 2007-02-04 |
Last Update Date | 2018-03-23 |
Gender Code | F |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 213EP1101X |
Podiatrist Specialization: Primary Podiatric Medicine |
520 | NC | Podiatric Medicine & Surgery Service Providers |
N | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
520 | NC | Podiatric Medicine & Surgery Service Providers |
Address | Telephone Number | Fax Number |
---|---|---|
25 Union School Rd Nw Ste 1, Ocean Isle Beach, NC 284697307 | 9105790828 |
Street Address |
1202 MEDICAL CENTER DR |
City | WILMINGTON |
State | NC |
Zip Code | 28401-7307 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1992704902 | Kyra F Williams | Physician Assistant | 1202 Medical Center Dr, Wilmington, NC 28401-7307 | 2005-07-20 |
1598389462 | Clara Wortham Robinson | Nurse Practitioner | 1202 Medical Center Dr, Wilmington, NC 28401-7307 | 2020-06-05 |
1225669435 | Dina Jane Sarro | Nurse Practitioner | 1202 Medical Center Dr, Wilmington, NC 28401-7307 | 2020-01-28 |
1538799861 | Brandy Rhodes | Nurse Practitioner | 1202 Medical Center Dr, Wilmington, NC 28401-7307 | 2020-01-26 |
1134654056 | Anna Paylor | Nurse Practitioner | 1202 Medical Center Dr, Wilmington, NC 28401-7307 | 2017-04-28 |
1518491927 | Wendy Laura Atkinson | Hospitalist | 1202 Medical Center Dr, Wilmington, NC 28401-7307 | 2017-04-13 |
1093247611 | Prasheen Piyush Shah | Hospitalist | 1202 Medical Center Dr, Wilmington, NC 28401-7307 | 2017-04-02 |
1871038463 | Justin Tilley | Physician Assistant | 1202 Medical Center Dr, Wilmington, NC 28401-7307 | 2017-01-05 |
1144681917 | Kathryn Elizabeth Davis | Nurse Practitioner | 1202 Medical Center Dr, Wilmington, NC 28401-7307 | 2016-03-08 |
1376916296 | Maria Mastoras | Nurse Practitioner | 1202 Medical Center Dr, Attn: Credentialing, Wilmington, NC 28401-7307 | 2015-11-02 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1275002461 | Thrivetothrive, LLC | Physical Therapist | 1606 Physicians Drive, Inside Promina Health, Wilmington, NC 28401 | 2018-11-16 |
1841787454 | Kevin Christopher Panebianco | Family Medicine | 1911 S 17th St Ste 130a, Wilmington, NC 28401 | 2018-04-18 |
1518472588 | Michelle Bruin | Family Medicine | 415 S. 2nd Street, Wilmington, NC 28401 | 2017-12-12 |
1639617343 | Anna Farwell | Behavior Technician | 3904 Oleander Dr. Suite 102, Wilmington, NC 28401 | 2017-02-02 |
1588034144 | Dimitri Zivko Pitovski | Allergy & Immunology | 1099 Medical Center Dr Unit 100b, Wilmington, NC 28401 | 2015-09-25 |
1629457007 | Megan Havel | Counselor | 1512 E Lakeshore Drive, Wilmington, NC 28401 | 2015-05-19 |
1154709251 | Lance Hutchens | Dentist | 1611 Doctors Cir, Wilmington, NC 28401 | 2015-05-11 |
1609281161 | Diane Pittman Whitford | Counselor | 313 Walnut St., Wilmington, NC 28401 | 2014-06-24 |
1942550728 | Bryan Cole Chalk | Nurse Anesthetist, Certified Registered | 2131 S 17th Street, Wilmington, NC 28401 | 2012-09-19 |
1740566546 | Valerie Baars | Pharmacist | 2302 S 17th Street, Wilmington, NC 28401 | 2011-10-25 |
Find all providers in zip 28401 |
Taxonomy Code | 213EP1101X |
Grouping | Podiatric Medicine & Surgery Service Providers |
Classification | Podiatrist |
Specialization | Primary Podiatric Medicine |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1023346335 | Heather M Rafal | Podiatrist | 1601 Milltown Rd Ste 24, Wilmington, DE 19808-4084 | 2009-11-24 |
1497722672 | Kevin Gregory Bachman | Podiatrist | 1602 Doctors Cir, Wilmington, NC 28401-7406 | 2006-03-07 |
1477527562 | Susie Nely Sant Anna | Podiatrist | 4113 Oleander Dr Ste G, Wilmington, NC 28403-6840 | 2006-02-15 |
1689676009 | Gregory Girard Young | Podiatrist | 1919 S 16th St, Wilmington, NC 28401-6610 | 2005-08-15 |
1528353638 | Derek Tyler Pantiel | Podiatrist | 4113 Oleander Dr, Ste G, Wilmington, NC 28403-6840 | 2011-06-16 |
1821302472 | Christiana Care Health Services Inc | Podiatrist | 501 W 14th St, Wilmington Hospital Health Center, Wilmington, DE 19801-1013 | 2010-08-05 |
1841488947 | The Cape Fear Foot Center | Podiatrist | 1919 S 16th St, Wilmington, NC 28401-6610 | 2007-10-15 |
1497723324 | Jeffrey Bruce Pupp | Podiatrist | 1602 Doctors Cir, Wilmington, NC 28401-7406 | 2006-03-08 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1073126223 | King Podiatry and Associates Pllc | Podiatrist | 5116 N Croatan Hwy, Kitty Hawk, NC 27949-3988 | 2020-08-27 |
1124475017 | Jeffrey Lynn Hunter | Podiatrist | 367 S Andy Griffith Pkwy # 200, Mount Airy, NC 27030 | 2016-05-20 |
1255773222 | Jacob A Panici | Podiatrist | 103 Parkway Office Ct Ste 100, Cary, NC 27518-7429 | 2013-07-19 |
1881038453 | Cardinal Podiatry, P.C. | Podiatrist | 1852 Banking St # 9043, Greensboro, NC 27408-7222 | 2013-04-25 |
1891007639 | Tori N Simmons Lewis | Podiatrist | 10370 Park Rd Ste 100, Charlotte, NC 28210-8509 | 2010-07-09 |
1437316361 | Paul J Keane Dpm | Podiatrist | 506 S Sutherland Ave, Monroe, NC 28112-5061 | 2008-05-19 |
1568542181 | Robert Charles Wingate | Podiatrist | 1050 South Peace Haven Road, Winston Salem, NC 27103-9788 | 2006-10-17 |
1275630295 | Chukwuma Ukata | Podiatrist | 516 Village Ct, Garner, NC 27529-3600 | 2006-09-20 |
1992810717 | Kevin C Mcdonald | Podiatrist | 1022 Lee Ann Dr Ne, Concord, NC 28025-2911 | 2006-08-20 |
1568484749 | Jennifer H Purvis | Podiatrist | 3301 Sunset Ave, Rocky Mount, NC 27804-3521 | 2006-07-24 |
Find all providers with the same taxonomy |
City | WILMINGTON |
Zip Code | 28401 |
Please comment or provide details below to improve the information on ROSE S SOUTHERLAND.
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.