KIDMED SOUTHSIDE PLC (NPI# 1477869337) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477869337 |
| Entity Type | Organization |
| Organization Name | KIDMED SOUTHSIDE PLC |
| Practice Address |
5021 Craig Rath Blvd Bldg Iv Midlothian VA 23112-6243 |
| Mailing Address |
4687 Pouncey Tract Rd Glen Allen VA 23059-5802 |
| Practice Telephone | 8044225437 |
| Practice Fax Number | 8044225438 |
| Mailing Telephone | 8044225437 |
| Mailing Fax Number | 8044225438 |
| Enumeration Date | 2010-08-28 |
| Last Update Date | 2020-02-28 |
| Authorized Official Name | DR. MARK ADAM FLANZENBAUM (PRESIDENT/MANAGING PARTNER) |
| Authorized Official Telephone | 8045925437 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | Y |
| Parent Organization Name | KIDMED INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QU0200X |
Clinic/Center Specialization: Urgent Care |
Ambulatory Health Care Facilities |
| Street Address |
5021 CRAIG RATH BLVD BLDG IV |
| City | MIDLOTHIAN |
| State | VA |
| Zip Code | 23112-6243 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396392254 | Tiah Charlye-arlene Cooke | Nurse Practitioner | 5021 Craig Rath Blvd, Midlothian, VA 23112-6243 | 2019-08-23 |
| 1891357331 | Lauren Marie Paugh | Registered Nurse | 5021 Craig Rath Blvd, Midlothian, VA 23112-6243 | 2019-07-04 |
| 1124437025 | Miranda Rose Lloyd | Nurse Practitioner | 5021 Craig Rath Blvd, Building Iv, Midlothian, VA 23112-6243 | 2014-08-05 |
| 1922440320 | Rebekah Russ Reinemeyer | Nurse Practitioner | 5021 Craig Rath Blvd, Bldg 4, Midlothian, VA 23112-6243 | 2013-07-25 |
| 1346515277 | Melanie Reed | Nurse Practitioner | 5021 Craig Rath Blvd, Bldg 4, Midlothian, VA 23112-6243 | 2012-03-10 |
| 1265702260 | Linda Catherine White | Nurse Practitioner | 5021 Craig Rath Blvd, Bldg 4, Midlothian, VA 23112-6243 | 2012-01-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982170080 | Shonmarra Ylexus Glover | Behavior Technician | 5950 Harbour Lane, Midlothian, VA 23112 | 2018-10-17 |
| 1841778917 | Brett Stires | Behavior Technician | 5950 Harbourt Park Dr, Midlothian, VA 23112 | 2018-08-01 |
| 1538655899 | Surbhi Chandna | Dentist | 5921 Harbour Ln Ste 500, Midlothian, VA 23112 | 2018-07-10 |
| 1184121584 | Katie Marie Kashmer | Behavioral Analyst | 5950 Barbour Park Lane, Midlothian, WA 23112 | 2018-04-11 |
| 1497259832 | Ruth Lynn Kitchens | Occupational Therapist | 13900 Hull Street Rd., Midlothian, VA 23112 | 2018-03-21 |
| 1487157301 | Susan Stoodt Price | Occupational Therapist | Chesterfield Technical Center Hull, 13900 Hull Street Rd., Midlothian, VA 23112 | 2018-03-16 |
| 1922500495 | Rayna Veney Piper | Speech-Language Pathologist | 13900 Hull Street Road, Midlothian, VA 23112 | 2018-03-01 |
| 1891202883 | Rochelle Wallace | Behavioral Analyst | 5950 Harbourt Park Dr., Midlothian, VA 23112 | 2017-12-29 |
| 1184138448 | Virginia Medical & Therapeutic Services | Counselor | 13540 E Boundary Rd, Midlothian, VA 23112 | 2017-11-24 |
| 1386169118 | Brandon Poen | Physical Therapist | 2820 Waterford Lake Dr., Unit 013, Midlothian, VA 23112 | 2017-08-14 |
| Find all providers in zip 23112 | ||||
| Taxonomy Code | 261QU0200X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Urgent Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609305721 | Ahcc II, LLC | Clinic/Center | 13553 Midlothian Turnpiike, Midlothian, VA 23113-2311 | 2017-06-12 |
| 1992138820 | Emergency Physicians Immediate Care Center 2 LLC | Clinic/Center | 6100 Harbourside Centre Loop, Midlothian, VA 23112-2170 | 2013-08-14 |
| 1598020679 | Emergency Physicians Immediate Care Center 1 Pllc | Clinic/Center | 6100 Harbourside Center Loop, Midlothian, VA 23112-2170 | 2012-07-05 |
| 1629342233 | Peds Care Ltd | Clinic/Center | 14404 Sommerville Ct, Midlothian, VA 23113-6835 | 2012-02-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881200764 | Total Healthcare | Clinic/Center | 2202 Daniels Creek Rd, Collinsville, VA 24078-1370 | 2020-09-16 |
| 1487284717 | Xcel Urgent Care LLC | Clinic/Center | 3517 S Jefferson St, Falls Church, VA 22041-3106 | 2020-01-27 |
| 1003446402 | Mwhc Urgent Care LLC | Clinic/Center | 10 Stafford Lakes Parkway, Stafford, VA 22406 | 2020-01-24 |
| 1942857297 | Quiet Heartbeat LLC | Clinic/Center | 101 King Arthurs Way Apt 203, Fredericksburg, VA 22406-6421 | 2019-08-21 |
| 1467914994 | Velocity Urgent Care, LLC | Clinic/Center | 7394 Harbour Towne Pkwy Ste 5, Suffolk, VA 23435-3473 | 2019-04-03 |
| 1710448022 | Shifa Health LLC | Clinic/Center | 9 Center St Ste 101, Stafford, VA 22556-8910 | 2019-03-28 |
| 1992279327 | Velocity Urgent Care, LLC | Clinic/Center | 16422 Navigation Dr, Woodbridge, VA 22191 | 2019-01-18 |
| 1104394766 | Ortho Oic Orthopaedic Immediate Care, LLC | Clinic/Center | 1701 Clarendon Blvd Ste 120, Arlington, VA 22209-4800 | 2018-11-12 |
| 1043795941 | Velocity Urgent Care, LLC | Clinic/Center | 2180 General Booth Blvd Ste F, Virginia Beach, VA 23454-5804 | 2018-09-27 |
| 1174005920 | Velocity Urgent Care, LLC | Clinic/Center | 1001 Centerbrooke Ln Ste 100, Suffolk, VA 23434-8663 | 2018-08-29 |
| Find all providers with the same taxonomy | ||||
| City | MIDLOTHIAN |
| Zip Code | 23112 |
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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.