IndividualActive
Charles Southerland, DPM
NPI 1306832944 · Foot & Ankle Surgery Podiatrist · Eagle Mountain, UT
Provider details
- NPI number
- 1306832944
- Entity type
- Individual
- Primary specialty
- Foot & Ankle Surgery PodiatristPodiatric Medicine & Surgery Service Providers
- Credential
- DPM
- Sex
- Male
- Sole proprietor
- No
- License
- 9244891-0501 (UT)
Specialties & taxonomies
Podiatric Medicine & Surgery Service Providers
Profile Score
Detailed profile(100/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
20 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
3 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
3435 E Pony Express Pkwy Ste 140
Eagle Mountain, UT 84005-5548
Phone: (801) 893-8811
Street-level locationGet directions
Mailing address
11300 Ne 2nd Avenue
Miami Shores, FL 33161
Additional practice locations (2)
- 1973 N State StProvo, UT 84604-1012Phone: (801) 373-2499Fax: (801) 373-5200
- 8822 S Redwood Rd Ste E121West Jordan, UT 84088-5763Phone: (801) 285-7060Fax: (801) 285-7061
Registry dates
- Enumerated
- 2005-09-20
- Last updated
- 2020-04-24
- Certified
- 2020-04-24
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.