Southside Physical Therapy Clinic

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

05001800A Issued in IN

Legal business name

SOUTHSIDE PHYSICAL THERAPY CLINIC

Practice address

3440 S Post Rd
Indianapolis, IN 46239-8301

Phone

(317) 862-2860

Fax

(317) 862-0928

NPI assigned

Apr 19, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Abol Dadfarmay

Title

Owner

Phone

(317) 826-8866

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1145404800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1346205598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8601 CREEKWOOD LN",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462369211",
            "telephone_number": "317-826-8866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3440 S POST RD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462398301",
            "telephone_number": "317-862-2860",
            "fax_number": "317-862-0928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHSIDE PHYSICAL THERAPY CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DADFARMAY",
        "authorized_official_first_name": "ABOL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "317-826-8866",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "05001800A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Southside Family Medical Group, LLC
• Southside Family Physicians, Inc
• Southside Internal Medicine PC
• Southside OB-GYN PC
• Southside Pediatrics, Inc.
• Southside Youth Council
• Southside Youth Council, Inc
• Lindsey Southwick
• Nathaniel Robert Southwick
• Elizabeth Alexandra Southwood, MSW

• Physical Therapist in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Physical Therapist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.