MICHAEL SOUTHWORTH (NPI# 1306822481) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306822481 |
| Entity Type | Individual |
| Full Name | MICHAEL SOUTHWORTH |
| Credential | MD |
| Practice Address |
6 Healthcare Dr Ste 1 Rochester NH 03867-4499 |
| Practice Telephone | 6039946400 |
| Practice Fax Number | 6039946443 |
| Mailing Telephone | 6039946400 |
| Mailing Fax Number | 6039946443 |
| Enumeration Date | 2005-12-20 |
| Last Update Date | 2019-05-06 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2086S0129X |
Surgery Specialization: Vascular Surgery |
013160 | ME | Allopathic & Osteopathic Physicians |
| Y | 2086S0129X |
Surgery Specialization: Vascular Surgery |
8539 | NH | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ME | 1306822481 | 05 | |
| HARVARD PILGRIM | AA7682 | 01 | |
| ANTHEM BLUE CROSS | 0105960Y0NH01 | 01 | |
| MAINE BLUE CROSS | 008585 | 01 | |
| NH | 3073850 | 05 | |
| NH | RAILROAD MEDICARE | P00923460 | 01 |
| NH | 30004276 | 05 | |
| AETNA | 0123485 | 01 | |
| MARTINS POINT | 020401332 | 01 | |
| ME | 299000099 | 05 |
| Street Address |
6 HEALTHCARE DR STE 1 |
| City | ROCHESTER |
| State | NH |
| Zip Code | 03867-4499 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063704997 | Christina Danielle Hurley | Physician Assistant | 6 Healthcare Dr Ste 1, Rochester, NH 03867-4499 | 2011-05-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801402862 | Allergy and Asthma Center | Allergy & Immunology | 161 Rochester Hill Road, Rochester, NH 03867 | 2020-09-16 |
| 1245874908 | Alicia Anne Magoon | Occupational Therapist | 105 Eastern Avenue, Rochester, NH 03867 | 2019-11-05 |
| 1124531801 | Amelia K Bailey | Behavioral Analyst | 36 Industrial Way Ste 10, Rochester, NH 03867 | 2017-11-16 |
| 1285183988 | Till Inc | Community/Behavioral Health | 20 Walnut Street Apt 2, Woburn, MA 03867 | 2016-09-23 |
| 1174070080 | Hope On Haven Hill, Inc | Substance Abuse Rehabilitation Facility | 326 Rochester Hill Rd, Rochester, NH 03867 | 2016-09-08 |
| 1710359468 | Silke Psula | Social Worker | 25 Old Dover Rd, Community Partners, Rochester, NH 03867 | 2015-10-21 |
| 1396129672 | Skyhaven Surgery Center LLC | Clinic/Center | 13 Healthcare Drive, Rochester, NH 03867 | 2015-07-16 |
| 1659788214 | Elizabeth Mary Solof | Case Management | 1 Old Dover Road, Suite 7, Rochester, NH 03867 | 2014-07-16 |
| 1447676754 | Granite State Express Care LLC | Clinic/Center | 120 Washington Street, Rochester, NH 03867 | 2014-03-11 |
| 1265630412 | Deborah Jo Emery | Counselor | One Old Dover Road, Suite #6, Rochester, NH 03867 | 2007-07-10 |
| Find all providers in zip 03867 | ||||
| Taxonomy Code | 2086S0129X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Vascular Surgery |
| A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407297260 | Ryan Patrick Lydon | Surgery | 1445 Portland Ave Ste 108, Rochester, NY 14621-3008 | 2013-07-09 |
| 1063749927 | Joseph Edward Geary | Surgery | 95 Council Rock Ave, 95 Council Rock Ave, Rochester, NY 14610-2501 | 2009-11-12 |
| 1063421691 | Ronen Haeem Jhirad | Surgery | 3525 Buffalo Rd, Rochester, NY 14624-1119 | 2006-08-05 |
| 1700856275 | Bradley M Sweda | Surgery | 1135 W University Dr Ste 230, Rochester, MI 48307-1890 | 2006-01-25 |
| 1134103054 | Michael C Stoner | Surgery | 200 White Spruce Blvd, Rochester, NY 14623-1605 | 2005-12-05 |
| 1679100937 | Jesse Chait | Surgery | 200 1st St Sw, Rochester, MN 55905-0002 | 2020-03-26 |
| 1235762972 | Mohammad Rachad Mohammad Walid Wehbe | Surgery | 601 Elmwood Avenue Box Surg, Rochester, NY 14642-8410 | 2020-02-21 |
| 1699235689 | Armin Farazdaghi | Surgery | 200 First Street Sw, Rochester, MN 55905-0001 | 2019-03-25 |
| 1376027409 | Sara Forsythe | Surgery | 601 Elmwood Ave, Rochester, NY 14642-0001 | 2018-09-25 |
| 1093210262 | Nolan C Cirillo-penn | Surgery | 200 1st St Sw, Rochester, MN 55905 | 2018-03-28 |
| Find all providers in ROCHESTER | ||||
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| 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.