NPIMap

Organization Active NPI

Southside Community Hospital, Inc.

  • Community Based Hospice Care Agency
  • Farmville, VA
National Provider Identifier
1508154048
Registry record updated Apr 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
SOUTHSIDE COMMUNITY HOSPITAL, INC.
Doing business as
Centra Hospice Farmville
Practice address
1705 E. 3Rd St.
Farmville, VA 23901
Phone
(434) 315-5000
NPI assigned
Jul 19, 2011
Organization subpart
Yes
Parent organization
SOUTHSIDE COMMUNITY HOSPITAL, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 25, 2025

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

Authorized official

Name
Doug Davenport
Title
Cfo
Phone
(434) 200-4798

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X Primary

Addresses

Primary practice location

1705 E. 3Rd St.
Farmville, VA 23901

Mailing address

PO Box 41000
Lynchburg, VA 24506-4100
Phone (434) 315-5000

Other names 1

  • Centra Hospice Farmville Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120910000408 VA Part A Provider - Hospice 6305756297 Practice locations: Farmville, VA

Hospice certification: CCN 491608

Legal name
SOUTHSIDE COMMUNITY HOSPITAL, INC.
Doing business as
CENTRA HOSPICE FARMVILLE
Certification status
Active
Provider type (POS)
Hospice
Participating since
Jan 23, 2013
Last certification
May 26, 2021
Ownership / control type
Other
Organization structure
CorporationNon-profit
Incorporated
Apr 27, 1926 in VA
Enrollment address
1705 E 3Rd St
Farmville, VA 23901-2938

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Hospice

Medicare Care Compare
Listed as
Centra Hospice FarmvilleCCN 491608
Ownership
Other
Certified
Jan 23, 2013
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Tax ID family
South Central Fam Med C5 organizations share this tax ID, including this one
Part of
South Central Fam Med C

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

713 Oak St
Farmville, VA 23901

Ownership & related parties

All disclosed owners & managing parties 16

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Rodney Newton Individual Corporate Director Jan 1, 2022
Robert Tonkinson Individual Corporate OfficerCfo Jan 1, 2025
Calvin Gray Individual Corporate Officer Jan 1, 2011
Corporate Director Jan 1, 2011
Rhonda B Algeier Individual Corporate Director Jul 13, 2018
Sharon Harrup Individual Corporate Officer Jan 1, 2011
Corporate Director Jan 1, 2011
Jessica Ownby Individual Corporate Director Jan 1, 2026
Kemper Beasley Individual Corporate Officer Jan 1, 2022
Richard J Tugman Individual Corporate OfficerCeo Jan 1, 2025
Harold Harris Individual Corporate Officer Jan 1, 2022
Timothy Tharpe Individual Corporate Director Jul 13, 2018
Cameron Patterson Individual Other May 14, 2020
Kimberly T Little Individual Corporate Director Jan 1, 2025
Christopher S Davis Individual Other May 14, 2020
Timothy Fritz Individual W-2 Managing EmployeeController Jan 1, 2022
William McGuire Individual Corporate Officer Jan 1, 2011
Corporate Director Jan 1, 2011
Bikram S Bal Individual Corporate Director Jul 13, 2018

Owners & managing parties with NPI records 3

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Affiliated clinicians 2

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1311033600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1745539200000",
    "number": "1508154048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 41000",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "245064100",
            "telephone_number": "434-315-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1705 E. 3RD ST.",
            "city": "FARMVILLE",
            "state": "VA",
            "postal_code": "23901",
            "telephone_number": "434-315-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHSIDE COMMUNITY HOSPITAL, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SOUTHSIDE COMMUNITY HOSPITAL, INC.",
        "enumeration_date": "2011-07-19",
        "last_updated": "2025-04-25",
        "certification_date": "2025-04-18",
        "status": "A",
        "authorized_official_last_name": "DAVENPORT",
        "authorized_official_first_name": "DOUG",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "434-200-4798"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Centra Hospice Farmville",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Centra Hospice Farmville",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Farmville, VA

Sources for this page

Verify at the official NPI Registry.