Southside Medical Management Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

SOUTHSIDE MEDICAL MANAGEMENT INC

Doing business as

Kenbridge Family Medicine

Practice address

306 E 6TH Ave
Kenbridge, VA 23944-2050

Phone

(434) 676-8021

Fax

(434) 447-2240

NPI assigned

Mar 12, 2014

Last updated

Feb 8, 2017By the provider in NPPES

Organization subpart

Yes

Parent organization

SOUTHSIDE MEDICAL MANAGEMENT INCAs reported in NPPES

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

Authorized official

Name

Graham H Powers III, MD

Title

Partner

Phone

(434) 584-2000

Specialties & licenses 4

Addresses

Other names 1

• Kenbridge Family Medicine Doing business as

Tax ID family

Southside Medical Management Inc4 organizations share this tax ID, including this one

Part of

Southside Medical Management Inc

Other organizations with this tax ID 3

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

• Southside Medical Management

  dba Kenbridge Family Medicine Inc RHC

  • Family Medicine Physician
  • Kenbridge, VA
  • NPI 1417373606
  NPD tax ID
• Southside Medical Management

  dba South HIll Family Medicine Inc RHC

  • Family Medicine Physician
  • South Hill, VA
  • NPI 1508282799
  NPD tax ID
• Southside Medical Management Inc

  dba South Hill Family Medicine

  • Family Medicine Physician
  • South Hill, VA
  • NPI 1770909921
  NPD tax ID

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

{
    "created_epoch": "1394582400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1486512000000",
    "number": "1689090839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "306 E 6TH AVE",
            "city": "KENBRIDGE",
            "state": "VA",
            "postal_code": "239442050",
            "telephone_number": "434-676-8021",
            "fax_number": "434-447-2240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "306 E 6TH AVE",
            "city": "KENBRIDGE",
            "state": "VA",
            "postal_code": "239442050",
            "telephone_number": "434-676-8021",
            "fax_number": "434-447-2240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHSIDE MEDICAL MANAGEMENT INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SOUTHSIDE MEDICAL MANAGEMENT INC",
        "enumeration_date": "2014-03-12",
        "last_updated": "2017-02-08",
        "status": "A",
        "authorized_official_last_name": "POWERS",
        "authorized_official_first_name": "GRAHAM",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "434-584-2000",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "VA",
            "license": "0024168641",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "VA",
            "license": "0024168845",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kenbridge Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Riccobene & Associates CC, DDS, PC (Commonwealth Dentistry - Kenbridge)
• Sandy Seward
• Doretha Jones Smith
• Smiths Pharmacy & Home Health Care Center of Kenbridge Inc (Smith's Pharmacy)
• Southside Medical Management (Kenbridge Family Medicine Inc RHC)
• Three Rivers Treatment Center LLC (Three Rivers Treatment Center)
• William Irby Jr DDS PC
• Kevin Witty, R.N.
• Cristyl Hawthorne Word, LPC, CSOTP

• Family Medicine Physician in Kenbridge, VA
• Providers in Kenbridge, VA by specialty
• Family Medicine Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2017; 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.