Southern Dominion Health System

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

SOUTHERN DOMINION HEALTH SYSTEM

Practice address

8631 Namozine Rd
Amelia Court House, VA 23002-3410

Phone

(804) 561-6263

NPI assigned

Mar 12, 2009

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Mary R Turner, CEO

Title

Chief Executive Officer

Phone

(434) 696-2165

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1236816000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1104067701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8631 NAMOZINE RD",
            "city": "AMELIA COURT HOUSE",
            "state": "VA",
            "postal_code": "230023410",
            "telephone_number": "804-561-6263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8631 NAMOZINE RD",
            "city": "AMELIA COURT HOUSE",
            "state": "VA",
            "postal_code": "230023410",
            "telephone_number": "804-561-6263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN DOMINION HEALTH SYSTEM",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-12",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "TURNER",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "434-696-2165",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "CEO"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "VA",
            "license": "0",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa April Pelletier, LPC
• Rapid Response Emergency Center PLC
• Crystal Marie Reams, BCBA, LBA
• Teresa Redford-Banton
• Samaritan Health Inc.
• Southern Dominion Health System, Inc.
• Blufort Spencer
• Catherine C Staley, DDS
• Tina Staples
• Keshia Monik Stephens, NP

• Clinic/Center in Amelia Court House, VA
• Providers in Amelia Court House, VA by specialty
• Clinic/Center in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.