| NPI | 1053789511 |
|---|---|
| NPI Type | NPI-2 Organization |
| Status | Active |
| Enumeration Date | 2015-09-14 |
| Last Updated | 2025-07-09 |
| Authorized Official | Masresha Kassa CFO Phone: 4046881350 |
| Mailing Address | 1046 Ridge Ave Sw Atlanta, GA 30315-1640 United States Phone: (404) 688-1350 | Fax: (404) 688-2962 📍 View Map |
| Primary Practice Address | 409 W Solomon St Griffin, GA 30223-2831 United States Phone: (678) 688-8700 📍 View Map |
| Primary | Taxonomy Code & Description | State | License Number |
|---|---|---|---|
| Yes | 261QF0400X – Clinic/Center, Federally Qualified Health Center (FQHC) | — | — |
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About NPI 1053789511
Southside Medical Center, Inc is an organization registered in the CMS NPPES NPI Registry with NPI number 1053789511. The primary specialty listed is Clinic/Center, Federally Qualified Health Center (FQHC). The organization is located in Griffin, GA. This NPI is classified as a Type 2 (Organizational) NPI and is currently active. The NPI was first enumerated (assigned) on 2015-09-14. All data is sourced directly from the official CMS NPPES public API and is updated daily.
Frequently Asked Questions
What is NPI 1053789511?
NPI 1053789511 belongs to Southside Medical Center, Inc, a Clinic/Center, Federally Qualified Health Center (FQHC) in Griffin, GA. It is a Type 2 Organizational NPI registered in the CMS NPPES NPI Registry.
Is NPI 1053789511 active?
The current status of NPI 1053789511 in the NPPES registry is Active. The record was last updated on 2025-07-09.
What specialty is NPI 1053789511?
NPI 1053789511 is classified under the taxonomy Clinic/Center, Federally Qualified Health Center (FQHC). Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.
How do I verify NPI 1053789511?
You can verify NPI 1053789511 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.
What address is on file for NPI 1053789511?
The primary practice address on file for NPI 1053789511 is 409 W Solomon St, Griffin, GA 30223-2831. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.
When was NPI 1053789511 issued?
NPI 1053789511 was first issued (enumerated) on 2015-09-14. The NPPES record was last updated on 2025-07-09.
Practice Location Map
Southside Medical Center, Inc is located at 409 W Solomon St, Griffin, GA. Use the map below to find directions or verify the practice location.
Related Healthcare Providers
The following providers share the same practice location, specialty, or state as Southside Medical Center, Inc. All records sourced from the CMS NPPES registry.