SOUTHSIDE MEDICAL CENTER PA (NPI# 1972782019) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972782019 |
| Entity Type | Organization |
| Organization Name | SOUTHSIDE MEDICAL CENTER PA |
| Practice Address |
3921 S Highway 14 Ste A Greenville SC 29615-6138 |
| Practice Telephone | 8642882006 |
| Practice Fax Number | 8642881678 |
| Mailing Telephone | 8642882006 |
| Mailing Fax Number | 8642881678 |
| Enumeration Date | 2007-10-25 |
| Last Update Date | 2007-10-25 |
| Authorized Official Name | DR. THAER JOUDEH (OWNER) |
| Authorized Official Telephone | 8642882006 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | 21696 | SC | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | 216965 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003099409 | Southside Medical Center Pa | Family Medicine | 1925a Oleander Dr, Wilmington, NC 28403-2334 | 2007-12-10 |
| Street Address |
3921 S HIGHWAY 14 STE A |
| City | GREENVILLE |
| State | SC |
| Zip Code | 29615-6138 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285146613 | Universal Therapeutic Services, LLC. | Early Intervention Provider Agency | 3921 S Highway 14 Ste A, Greenville, SC 29615-6138 | 2017-10-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194358051 | Adenike Orogade | Behavior Technician | 17 Caldedon Ct, Suite B, Greenville, SC 29615 | 2020-02-19 |
| 1629608369 | Jennifer Jacobsen | Behavior Technician | 17 Caldedon Court, Suite B, Greenville, SC 29615 | 2020-01-22 |
| 1932668217 | Carolina Orthopaedic and Neurosurgical Associates | Orthopaedic Surgery | Carolina Orthopaedic and Neurosurgical Associates, 220 Roper Mountain Road Extension, Greenville, SC 29615 | 2019-03-18 |
| 1255816070 | Trevis L Cureton | Pharmacist | 2401 East North St, Greenville, SC 29615 | 2018-09-27 |
| 1497232565 | Jacob J Fountain | Nurse Practitioner | 225 Enterprise Blvd, Suite 101, Greenville, SC 29615 | 2018-07-23 |
| 1346726924 | St. Francis Physician Services, Inc | Internal Medicine | 5 Hoke Smith Blvd, Greenville, SC 29615 | 2018-07-17 |
| 1558853101 | Alexandra Michelle Taylor | Audiologist | 200 Patewood Dr Ste 400, Greenville, SC 29615 | 2018-05-30 |
| 1316466543 | Mariah Hope Mosher | Behavioral Analyst | 7 Mckenna Commons Court, Greenvilee, SC 29615 | 2017-09-19 |
| 1326400896 | Karen L Heaps | Counselor | 3150 S. Hwy 14, The Pelham Center, Greenville, SC 29615 | 2016-03-24 |
| 1134589013 | Sharon Erk | Technician, Other | 2950 E.norths St, Greenville, OH 29615 | 2016-03-04 |
| Find all providers in zip 29615 | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649802497 | Regenerative Health 360 LLC | Clinic/Center | 429 Roper Mountain Rd Ste 150, Greenville, SC 29615-4265 | 2020-02-10 |
| 1134688989 | Jean Barker Md Inc | Clinic/Center | 1659 E Union St, Greenville, MS 38703-3267 | 2019-03-19 |
| 1063909539 | Np Healthcare Clinic | Clinic/Center | 559a Highway 1 N, Greenville, MS 38701-3136 | 2018-04-19 |
| 1033638531 | Healthworks Med Group of South Carolina P C | Clinic/Center | 244 Terminal Rd Bldg 1045, Greenville, SC 29605-5508 | 2017-09-15 |
| 1659816932 | Proactive Md Sc,p.a. | Clinic/Center | 223 Adley Way, Greenville, SC 29607-6511 | 2016-12-22 |
| 1619336344 | John R Rowell Md21640 | Clinic/Center | 309 Belmont Ave, Greenville, SC 29601-4303 | 2016-02-23 |
| 1194192468 | Hammond Assessment Services, P.a. | Clinic/Center | 355 Woodruff Rd Ste 101, Greenville, SC 29607-3419 | 2015-08-21 |
| 1619394335 | Passport Health Holdings, LLC | Clinic/Center | 37 Villa Rd Ste 301, Greenville, SC 29615-3038 | 2014-03-19 |
| 1295157139 | Healthworks Med Group of South Carolina P C | Clinic/Center | 300 Garlington Rd, Greenville, SC 29615-4614 | 2014-01-13 |
| 1265779649 | Kristy D. Fox | Clinic/Center | 824 Mercer Rd, Greenville, PA 16125-8416 | 2013-01-06 |
| Find all providers in GREENVILLE | ||||
| City | GREENVILLE |
| Zip Code | 29615 |
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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.