Southside Emergency Physicians PC

Primary specialty

Personal Emergency Response AttendantTaxonomy code 146D00000X

Legal business name

SOUTHSIDE EMERGENCY PHYSICIANS PC

Practice address

2204 Wilborn Ave
South Boston, VA 24592-1645

Phone

(434) 517-3832

Fax

(434) 517-3649

NPI assigned

Aug 21, 2006

Organization subpart

No

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

Authorized official

Name

Cecil F Hazelwood

Title

Operations Manager

Phone

(434) 517-3515

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1346356631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1115",
            "city": "SOUTH BOSTON",
            "state": "VA",
            "postal_code": "245921115",
            "telephone_number": "434-517-3515",
            "fax_number": "434-572-4549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2204 WILBORN AVE",
            "city": "SOUTH BOSTON",
            "state": "VA",
            "postal_code": "245921645",
            "telephone_number": "434-517-3832",
            "fax_number": "434-517-3649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHSIDE EMERGENCY PHYSICIANS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HAZELWOOD",
        "authorized_official_first_name": "CECIL",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "OPERATIONS MANAGER",
        "authorized_official_telephone_number": "434-517-3515"
    },
    "taxonomies": [
        {
            "code": "146D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Personal Emergency Response Attendant",
            "state": "VA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Personal Emergency Response Attendant in South Boston, VA
• Providers in South Boston, VA by specialty
• Personal Emergency Response Attendant in Virginia

• 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.