DR. CHARLES C SOUTHERLAND (DPM) – Foot & Ankle Surgery Podiatrist, NPI 1306832944
Foot & Ankle Surgery Podiatrist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for DR. CHARLES C SOUTHERLAND (DPM)
Barry University, 11300, Northeast 2nd Avenue, Miami Shores, Miami-Dade County, Florida, 33161, United States
MIAMI SHORES, FL 33161
Phone: (305) 693-7287
Fax: (305) 694-9616
Type: Mailing
3435 E PONY EXPRESS PKWY STE 140
EAGLE MOUNTAIN, UT 840055548
Phone: (801) 893-8811
Type: Location
8822 S Redwood Rd Ste E121
West Jordan, UT 840885763
Phone: (801) 285-7060
Fax: (801) 285-7061
Type: Location
1973 N State St
Provo, UT 846041012
Phone: (801) 373-2499
Fax: (801) 373-5200
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
Loading prescription activity...
Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2011-09-29
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20110929000653 | I | Podiatry | FL | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 33161)
Loading plans...
Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| PODIATRY | FL | 73630 | X-ray of foot, minimum of 3 views | 15 | 12 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| P O D I A T R Y | UT | |
| P O D I A T R Y | UT | |
| P O D I A T R Y | UT | |
| P O D I A T R Y | UT | |
| P O D I A T R Y | UT | |
| P O D I A T R Y | UT | |
| P O D I A T R Y | UT | |
| P O D I A T R Y | UT |
Reviews
All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.
No reviews yet. Be the first to share your experience — your opinion helps families compare providers.