NPIMap

Organization Active NPI

Southside Therapy Associates, Inc.

Doing business as Progressive Therapy

  • Physical Therapist
  • Farmville, VA
National Provider Identifier
1306839089
Registry record updated Jan 24, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
SOUTHSIDE THERAPY ASSOCIATES, INC.
Doing business as
Progressive Therapy
Practice address
1412 W 3Rd St
Farmville, VA 23901-2648
Phone
(434) 392-1596
Fax
(434) 392-5201
NPI assigned
Aug 26, 2005
Last updated
Jan 24, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2012

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

Authorized official

Name
Kim Hudgins
Title
Director of Business Affairs
Phone
(434) 392-4910

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X Primary
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X

Addresses

Primary practice location

1412 W 3Rd St
Farmville, VA 23901-2648

Mailing address

PO Box 468
Farmville, VA 23901-0468
Phone (434) 392-4910

Other names 1

  • Progressive Therapy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120221001035 VA Part A Provider - Outpatient Physical Therapy/Occupational Therapy/Speech Pathology Services 5092973149 Practice locations: Blackstone, VA; Dillwyn, VA; Farmville, VA

National Provider Directory

National Provider Directory

Locations

104 W Broad St
Blackstone, VA 23824
Phone (434) 298-0141

1154 Main St
Dillwyn, VA 23936
Phone (434) 983-6544

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1125014400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1327363200000",
    "number": "1306839089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 468",
            "city": "FARMVILLE",
            "state": "VA",
            "postal_code": "239010468",
            "telephone_number": "434-392-4910",
            "fax_number": "434-392-8793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1412 W 3RD ST",
            "city": "FARMVILLE",
            "state": "VA",
            "postal_code": "239012648",
            "telephone_number": "434-392-1596",
            "fax_number": "434-392-5201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHSIDE THERAPY ASSOCIATES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-26",
        "last_updated": "2012-01-24",
        "status": "A",
        "authorized_official_last_name": "HUDGINS",
        "authorized_official_first_name": "KIM",
        "authorized_official_title_or_position": "DIRECTOR OF BUSINESS AFFAIRS",
        "authorized_official_telephone_number": "434-392-4910"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Progressive Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Farmville, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.