NPIMap

Organization Active NPI

Southside OB/GYN P.C.

  • Obstetrics & Gynecology Physician
  • Mooresville, IN
National Provider Identifier
1285909002
Registry record updated Dec 14, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
02001767A Issued in IN
Legal business name
SOUTHSIDE OB/GYN P.C.
Practice address
1205 Hadley Rd
Mooresville, IN 46158-1737
Phone
(317) 584-3454
Fax
(317) 584-3435
NPI assigned
Mar 12, 2012
Organization subpart
Yes
Parent organization
SOUTHSIDE OB/GYN P.C.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 14, 2017

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

Authorized official

Name
Ms. Jocelyn Forehand, CMPE, CPC
Title
Ceo
Phone
(317) 865-3600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207V00000X 02001767A IN Primary

Addresses

Primary practice location

1205 Hadley Rd
Mooresville, IN 46158-1737

Mailing address

8051 S Emerson Ave
400
Indianapolis, IN 46237-8600
Phone (317) 865-3600

Other identifiers 1

IdentifierTypeStateIssuer
100047770MedicaidIN

National Provider Directory

National Provider Directory
Part of
Southside OB-GYN PC

Locations

8051 S Emerson Ave
Ste 400
Indianapolis, IN 46237
Phone (317) 865-3600

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1331510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1513209600000",
    "number": "1285909002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8051 S EMERSON AVE",
            "address_2": "400",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462378600",
            "telephone_number": "317-865-3600",
            "fax_number": "317-885-3850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1205 HADLEY RD",
            "city": "MOORESVILLE",
            "state": "IN",
            "postal_code": "461581737",
            "telephone_number": "317-584-3454",
            "fax_number": "317-584-3435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHSIDE OB/GYN P.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SOUTHSIDE OB/GYN P.C.",
        "enumeration_date": "2012-03-12",
        "last_updated": "2017-12-14",
        "status": "A",
        "authorized_official_last_name": "FOREHAND",
        "authorized_official_first_name": "JOCELYN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "317-865-3600",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "CMPE, CPC"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "IN",
            "license": "02001767A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100047770",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mooresville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2017; 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.