SOUTHSIDE OB-GYN, INC. (NPI# 1316150006) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316150006 |
| Entity Type | Organization |
| Organization Name | SOUTHSIDE OB-GYN, INC. |
| Practice Address |
600 S Sycamore St Petersburg VA 23803-5815 |
| Practice Telephone | 8047320136 |
| Practice Fax Number | 8048619661 |
| Mailing Telephone | 8047320136 |
| Mailing Fax Number | 8048619661 |
| Enumeration Date | 2007-05-08 |
| Last Update Date | 2008-04-20 |
| Authorized Official Name | DR. HENRY LOUIS TOMLIN (PRESIDENT) |
| Authorized Official Telephone | 8047320136 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | 0101029081 | VA | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | MDIPA OPTIMUM CHOICE | 213198 | 01 |
| VA | ANTHEM | 070725 | 01 |
| VA | CIGNA | 212033 | 01 |
| Street Address |
600 S SYCAMORE ST |
| City | PETERSBURG |
| State | VA |
| Zip Code | 23803-5815 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225642952 | Pearls Center of Hope, LLC | Peer Specialist | 600 S Sycamore St, Petersburg, VA 23803-5815 | 2020-09-01 |
| 1710361936 | Droz Rehab LLC | Physical Medicine & Rehabilitation | 600 S Sycamore St, Petersburg, VA 23803-5815 | 2015-07-17 |
| 1992736698 | Henry Louis Tomlin | Obstetrics & Gynecology | 600 S Sycamore St, Petersburg, VA 23803-5815 | 2006-07-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619523719 | Wise Journey Ltd | Home Health | 325-b Brown Street Suite 132, Petersburg, VA 23803 | 2019-08-14 |
| 1386101699 | Marliqua Barnes | Driver | 601 Carter St, Petersburg, VA 23803 | 2019-02-22 |
| 1356596571 | Quality Healthcare Inc | Community/Behavioral Health | 6111 Duncan Rd, Ste F, Petersburg, VA 23803 | 2008-12-02 |
| 1861614943 | Peoples Family Dental Care | Dentist | 1328 W Washington St, Petersburg, VA 23803 | 2007-05-02 |
| 1841333721 | Family Preservation Services, Inc | Community/Behavioral Health | 1000 Patterson Ave, Petersburg, VA 23803 | 2007-02-14 |
| 1154473155 | Progressive Adult Rehabilitation Center, Inc. | Day Training, Developmentally Disabled Services | 114 North Union Street, Suite B, Petersburg, VA 23803 | 2007-01-18 |
| 1861556615 | Evelyn V. Whitehead | Counselor | 115 E Wythe St, Petersburg, VA 23803 | 2006-12-19 |
| 1538248778 | Raymond Gibson Smith Jr. | Dentist | Seventh Avenue, Hiram Davis Medical Center, Petersburg, VA 23803 | 2006-11-06 |
| 1396842282 | Eugene Arthur Richardson IIi | Dentist | 23 Shore Street, Petersburg, VA 23803 | 2006-09-20 |
| 1679594030 | Olumuyiwa Akinniyi Ojediran | Internal Medicine | 734 South Sycamore Street, Petersburg, VA 23803 | 2006-07-21 |
| Find all providers in zip 23803 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083754790 | Professional Health Care, Inc. | Specialist | 849 S Sycamore St, Suite E, Petersburg, VA 23803-5801 | 2007-02-08 |
| 1457311656 | Myung-sup Kim Md Pa | Specialist | Rt 55 West, Petersburg, WV 26847 | 2006-03-23 |
| 1023086915 | Frank F Shieh | Specialist | 603 S Sycamore St, Petersburg, VA 23803 | 2006-03-08 |
| 1972983393 | Grant Memorial Hospital | Specialist | 65 Hospital Dr Ste 103, Petersburg, WV 26847-9549 | 2015-06-01 |
| 1497872980 | Team Rehab, Inc | Specialist | 95 Medical Park Blvd, Petersburg, VA 23805-9280 | 2007-03-22 |
| 1447365945 | Central Virginia Oncology, Inc. | Specialist | 700 S Sycamore St, Ste 10, Petersburg, VA 23803 | 2006-08-21 |
| 1447205554 | Russell Johnson | Specialist | 601 Old Wagner Rd, Suite 101, Petersburg, VA 23805-9313 | 2006-05-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457952004 | Patricia Maureen Williams | Specialist | 175 W Campus Dr, 110 Lr Hall, Blacksburg, VA 24061-1034 | 2020-11-02 |
| 1497360028 | Ann L Swanson | Specialist | 872 Garrow Rd, Newport News, VA 23608-3365 | 2020-09-10 |
| 1093338915 | Bridget Elizabeth Poindexter | Specialist | 103 Madison St Apt C, Radford, VA 24141-1878 | 2020-05-27 |
| 1285257246 | Zamjams Enterprises LLC | Specialist | 1600 N Coalter St Ste 7, Staunton, VA 24401-2500 | 2020-05-26 |
| 1427670538 | Megan Cone | Specialist | 6236 Willow Glen Rd, Midlothian, VA 23112-2230 | 2020-05-12 |
| 1033739529 | Maureen Marguerite Loftus | Specialist | 8321 Old Courthouse Rd Ste 130, Vienna, VA 22182-3817 | 2020-04-24 |
| 1972132090 | Alissa S Rexo | Specialist | 25251 Beach Place, Chantilly, VA 20152 | 2020-04-02 |
| 1821626235 | Tidewater Surgical | Specialist | 1732 S Park Ct, Chesapeake, VA 23320-8934 | 2020-03-31 |
| 1699307520 | Latia Tisdale | Specialist | 2520 Professional Rd Ste D, North Chesterfield, VA 23235-3267 | 2020-02-08 |
| 1013473081 | Whitney Matheson | Specialist | 6803 Dallas Rd, Roanoke, VA 24019-2310 | 2019-02-14 |
| Find all providers with the same taxonomy | ||||
| City | PETERSBURG |
| Zip Code | 23803 |
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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.