NPIMap

Southside Medical Center, Inc.

A Medicare group practice based in Atlanta, GA: 15 NPIs enrolled under one PECOS associate control ID (PAC ID 6901700723), with 102 clinicians.

Medicare enrollment

Medicare enrollment files
PAC ID
6901700723The PECOS associate control ID: one enrolled organization, which may hold several NPIs
Provider type
Part A Provider - Federally Qualified Health Center (FQHC), Part B Supplier - Clinic/Group Practice, Part B Supplier - Opioid Treatment Program (Otp)
Enrolled in
GA
Enrollments
17
Group size
12 cliniciansAs Care Compare reports it
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Practice locations
23In 13 places

Enrollment records 17

Enrollment IDStateProvider typeNPI
O20031203000053 GA Part A Provider - Federally Qualified Health Center (FQHC) 1235123993
O20031212000357 GA Part B Supplier - Clinic/Group Practice 1235123993
O20031229000661 GA Part A Provider - Federally Qualified Health Center (FQHC) 1730207663
O20031229000372 GA Part A Provider - Federally Qualified Health Center (FQHC) 1831217488
O20050505000488 GA Part A Provider - Federally Qualified Health Center (FQHC) 1427175090
O20230303000186 GA Part A Provider - Federally Qualified Health Center (FQHC) 1861129850
O20251120001249 GA Part A Provider - Federally Qualified Health Center (FQHC) 1467325910
O20251126003694 GA Part A Provider - Federally Qualified Health Center (FQHC) 1821981234
O20250108001250 GA Part A Provider - Federally Qualified Health Center (FQHC) 1144041062
O20200201000020 GA Part B Supplier - Opioid Treatment Program (Otp) 1174641658
O20211025001256 GA Part A Provider - Federally Qualified Health Center (FQHC) 1467027482
O20170523001570 GA Part A Provider - Federally Qualified Health Center (FQHC) 1629510466
O20151113000268 GA Part A Provider - Federally Qualified Health Center (FQHC) 1053789511
O20140707001385 GA Part A Provider - Federally Qualified Health Center (FQHC) 1588088025
O20130531000045 GA Part A Provider - Federally Qualified Health Center (FQHC) 1962529529
O20120926000592 GA Part A Provider - Federally Qualified Health Center (FQHC) 1922125574
O20100929001648 GA Part A Provider - Federally Qualified Health Center (FQHC) 1174641658

NPIs in this group 15

NPPES NPI Registry

These NPI records belong to the same enrolled organization. Each has its own page.

Practice locations

Locations on the Medicare enrollment

Clinicians 102

Page 1 of 2

Clinicians who reassign their Medicare benefits to this group (99) or whom Care Compare lists as members (12).

Sources for this page