Southside VA Family Young Men'S Christian Association

Primary specialty

Health EducatorTaxonomy code 174H00000X

Legal business name

SOUTHSIDE VA FAMILY YOUNG MEN'S CHRISTIAN ASSOCIATION

Practice address

580 Commerce Rd
Farmville, VA 23901-2999

Phone

(434) 392-3456

NPI assigned

Dec 30, 2016

Organization subpart

No

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

Authorized official

Name

Ben Sysko

Title

Ceo

Phone

(434) 392-3456

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1483056000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1483056000000",
    "number": "1609311679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "580 COMMERCE RD",
            "city": "FARMVILLE",
            "state": "VA",
            "postal_code": "239012999",
            "telephone_number": "434-392-3456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "580 COMMERCE RD",
            "city": "FARMVILLE",
            "state": "VA",
            "postal_code": "239012999",
            "telephone_number": "434-392-3456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHSIDE VA FAMILY YOUNG MEN'S CHRISTIAN ASSOCIATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-30",
        "last_updated": "2016-12-30",
        "status": "A",
        "authorized_official_last_name": "SYSKO",
        "authorized_official_first_name": "BEN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "434-392-3456"
    },
    "taxonomies": [
        {
            "code": "174H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Health Educator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Southside Medical Practice PLLC
• Southside Optical Center LLC
• Southside Orthopedic Associates, PC
• Southside Therapy Associates, Inc.
• Southside Urology Clinic PC
• Sozo Healthcare, LLC
• St. John Legacy LLC
• Stephen H Goldberger, MD
• James Ray Stephens, DDS
• Sterling Emergency Services of Virginia Inc

• Health Educator in Farmville, VA
• Providers in Farmville, VA by specialty
• Health Educator in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2016; 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.