SAMUEL LYNN SOUTHAM MD NPI 1104868850

NPI Information

  • NPI: 1104868850
  • Provider Name: SAMUEL LYNN SOUTHAM, MD
  • Classification: Radiology - 2085R0202X
  • Specialization: Diagnostic Radiology
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 1034 N 500 W
    PROVO, UT
    ZIP 84604
  • Phone: (801) 357-7850

Map and Directions

Get Directions

NPI Details

Samuel Lynn Southam, MD is a diagnostic radiology radiology in Provo, UT with 22 years of experience. The provider is a radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. Samuel Lynn Southam, MD NPI is 1104868850. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: UNIVERSITY OF COLORADO SCHOOL OF MEDICINE, DENVER
Graduation Year:2003

The provider's business location address is:

1034 N 500 W
PROVO, UT
ZIP 84604-380
Phone: (801) 357-7850
Fax: (801) 357-7626

The NPI 1104868850 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • X-ray of chest, 1 view (HCPCS:71045)
  • Ct scan of abdomen and pelvis with contrast (HCPCS:74177)
  • Ct scan head or brain without contrast (HCPCS:70450)
  • X-ray of chest, 2 views (HCPCS:71046)
  • Ct scan of blood vessels of chest with contrast (HCPCS:71275)
  • Mri scan of leg joint without contrast (HCPCS:73721)
  • Ct scan of abdomen and pelvis without contrast (HCPCS:74176)
  • X-ray of abdomen, 1 view (HCPCS:74018)
  • X-ray of hip, 2-3 views (HCPCS:73502)
  • Mri scan of lower spinal canal without contrast (HCPCS:72148)
  • Ct scan of chest with contrast (HCPCS:71260)
  • X-ray of knee, 3 views (HCPCS:73562)
  • Mri scan of arm joint without contrast (HCPCS:73221)
  • Ct scan of leg without contrast (HCPCS:73700)
  • Ct scan of chest without contrast (HCPCS:71250)
  • X-ray of lower and sacral spine, 2-3 views (HCPCS:72100)
  • X-ray of shoulder, minimum of 2 views (HCPCS:73030)
  • Mri scan of leg joint without contrast (HCPCS:73721)
  • Ultrasound study of one arm or leg veins with compression and maneuvers (HCPCS:93971)
  • Mri scan of arm joint without contrast (HCPCS:73221)
  • Ct scan of lower spine without contrast (HCPCS:72131)
  • X-ray of knee, 1-2 views (HCPCS:73560)
  • X-ray of chest, 2 views (HCPCS:71046)
  • Ct scan of upper spine without contrast (HCPCS:72125)
  • Complete ultrasound scan behind abdominal cavity (HCPCS:76770)
  • Mri scan of lower spinal canal without contrast (HCPCS:72148)
  • X-ray of ankle, minimum of 3 views (HCPCS:73610)
  • Limited ultrasound scan of abdomen (HCPCS:76705)
  • X-ray of lower leg, 2 views (HCPCS:73590)
  • X-ray of pelvis, 1-2 views (HCPCS:72170)
  • X-ray of foot, minimum of 3 views (HCPCS:73630)
  • Ct scan of blood vessels of neck with contrast (HCPCS:70498)
  • Ultrasound study of arm or leg veins with compression and maneuvers (HCPCS:93970)
  • Mri scan of leg without contrast (HCPCS:73718)
  • Ct scan of blood vessels of head with contrast (HCPCS:70496)
  • Ct scan of middle spine without contrast (HCPCS:72128)
  • X-ray of wrist, minimum of 3 views (HCPCS:73110)
  • X-ray of hand, minimum of 3 views (HCPCS:73130)
  • Mri scan of leg before and after contrast (HCPCS:73720)
  • Ct scan of abdomen and pelvis before and after contrast (HCPCS:74178)
  • Mri scan of arm joint with contrast (HCPCS:73222)
  • Mri scan of upper spinal canal without contrast (HCPCS:72141)
  • X-ray of thigh bone, minimum 2 views (HCPCS:73552)
  • Mri scan of upper spinal canal without contrast (HCPCS:72141)
  • Ct scan of arm without contrast (HCPCS:73200)
  • X-ray of upper spine, 2-3 views (HCPCS:72040)
  • Ultrasound scan of head and neck soft tissue (HCPCS:76536)

The enumeration date for this NPI number is 6/10/2006 and was last updated on 6/10/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
12085R0202XRadiologyDiagnostic Radiology2005-0536NEW MEXICOYes
22085R0202XRadiologyDiagnostic Radiology12285899-1205UTAHNo

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
176673855MEDICAIDNEW MEXICO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.