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SOUTHSIDE MEDICAL MANAGEMENT INC NPI 1770909921


NPI Information

NPI: 1770909921
Provider Name: SOUTHSIDE MEDICAL MANAGEMENT INC

Doing Business As: SOUTH HILL FAMILY MEDICINE

Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 49D2180477

Address:
514 W ATLANTIC ST
SOUTH HILL, VA
ZIP 23970
Phone: (434) 584-2000
Get Directions

SOUTHSIDE MEDICAL MANAGEMENT INC is a family medicine in South Hill, VA. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. SOUTHSIDE MEDICAL MANAGEMENT INC NPI is 1770909921. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As South Hill Family Medicine.

The provider's business location address is:

514 W ATLANTIC ST
SOUTH HILL, VA
ZIP 23970-906
Phone: (434) 584-2000
Fax: (434) 447-2240

The provider's authorized official is Grahanm H Powers .
The authorized official title is Partner and has the following contact phone number (434) 584-2000.

The CLIA number assigned to this NPI record is 49D2180477 - ancillary testing site in health care center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/12/2014 and was last updated on 2/1/2017.


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
1207Q00000XFamily MedicineVIRGINIAYes
2207R00000XInternal Medicine0101040317VIRGINIANo
3207RE0101XInternal MedicineEndocrinology, Diabetes & Metabolism0101040317VIRGINIANo
4208000000XPediatrics0101042014VIRGINIANo
5363LP0200XNurse PractitionerPediatricsVIRGINIANo
6363AM0700XPhysician AssistantMedical0110002166VIRGINIANo
7363LA2200XNurse PractitionerAdult Health0024168641VIRGINIANo
8363LF0000XNurse PractitionerFamilyVIRGINIANo

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
1C03575MEDICARE PINVIRGINIA

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: 5/5/2024

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