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SOUTHERN REGIONAL MEDICAL CENTER
NPI 1154795581
General Acute Care Hospital in Riverdale, GA

Active since November 23, 2015CLIA 11D0021026 · Accreditation
11 UPPER RIVERDALE RD SW, RIVERDALE, GA 30274(770) 991-8000 Get Directions Write a Review

NPPES record last updated: September 14, 2021. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Sep 14, 2021, Feb 23, 2017, Nov 23, 2015 (3 updates tracked since 2015).

About Southern Regional Medical Center NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SOUTHERN REGIONAL MEDICAL CENTER (NPI 1154795581) is a healthcare organization registered as a general acute care hospital in Riverdale, Georgia and active in the NPI registry since November 2015. The organization holds an CLIA Accreditation certificate valid through February 27, 2027 and lists Christopher Doan, Managing Associate General Counsel, as its authorized official.

NPPES Registry Identity

NPI1154795581
Entity TypeOrganization
Primary Taxonomy282N00000X
Legal Business NamePRIME HEALTHCARE FOUNDATION - SOUTHERN REGIONAL, LLC
Location Address11 UPPER RIVERDALE RD SWRiverdale, GA 30274-2615
Mailing Address11 Upper Riverdale Rd SwRiverdale, GA 30274-2615 · (770) 991-8000
Phone(770) 991-8000
Organization SubpartNo
Authorized OfficialChristopher DoanManaging Associate General Counsel · (310) 259-4706
Enumeration DateNovember 23, 2015
Last NPPES UpdateSeptember 14, 20213 updates tracked since enumeration
NPPES CertifiedSeptember 14, 2021
✔ NPI 1154795581 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyGeneral Acute Care HospitalHospitals
Taxonomy Code282N00000X
License✔ Licensed in GA · 031-442
Definition
An acute general hospital is an institution whose primary function is to provide inpatient diagnostic and therapeutic services for a variety of medical conditions, both surgical and non-surgical, to a wide population group. The hospital treats patients in an acute phase of illness or injury, characterized by a single episode or a fairly short duration, from which the patient returns to his or her normal or previous level of activity.
Also ListedInternal Medicine · Cardiovascular DiseaseTaxonomy 207RC0000X
11 UPPER RIVERDALE RD SW, Riverdale, GA 30274
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Other Names 1

Doing Business AsSouthern Regional Medical Center

Other Identifiers 1

Medicaid00000404AGA

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Mending Health.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Accreditation 11D0021026

Southern Regional Medical Center · Riverdale, GA
Active · expires Feb 27, 2027
CLIA Number11D0021026
Laboratory TypeHospital
Certificate Effective DateFebruary 28, 2025
Certificate Expiration DateFebruary 27, 2027
Laboratory DirectorDr. Laleh Ehsani
Laboratory Phone(770) 991-8155
Laboratory LocationSouthern Regional Medical Center11 Upper Riverdale Rd SW Attn Doral Moore, Laboratory, Riverdale, GA 30274
CLIA data matches this NPI record on: Address Name
This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KAREN KRECHMERY NP
Nurse Practitioner
11 UPPER RIVERDALE RD SW
RIVERDALE, GA 30274
Clayton County (770) 994-9326
GEORGIA HOSPITALISTS GROUP, LLC
Hospitalist
11 UPPER RIVERDALE RD SW
RIVERDALE, GA 30274
Clayton County (770) 991-8000
SOUTHERN REGIONAL PHYSICIANS MANAGEMENT GROUP, LLC
Surgery
11 UPPER RIVERDALE RD SW
RIVERDALE, GA 30274
Clayton County (770) 991-8000
CHRISTOPHER I LACY MD
Radiology (Diagnostic Radiology)
11 UPPER RIVERDALE RD SW
RIVERDALE, GA 30274
Clayton County (770) 991-8000
HARMONY GROVE EMERGENCY PHYSICIANS LLC
Emergency Medicine
11 UPPER RIVERDALE RD SW
RIVERDALE, GA 30274
Clayton County (973) 251-1132
DR. NANCY ELIZABETH NEWTON M.D.
Pathology (Anatomic Pathology & Clinical Pathology)
11 UPPER RIVERDALE RD SW
RIVERDALE, GA 30274
Clayton County (770) 991-8615
DR. LILIAN OMO ODION-OMONHIMIN MD
Student in an Organized Health Care Education/Training Program
11 UPPER RIVERDALE RD SW
RIVERDALE, GA 30274
Clayton County (770) 991-8026
NATASHA SMITH MD
Emergency Medicine
11 UPPER RIVERDALE RD SW
RIVERDALE, GA 30274
Clayton County (770) 994-9326

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Prime Healthcare Foundation - Southern Regional, LLC's NPI number?

The NPI number for Prime Healthcare Foundation - Southern Regional, LLC is 1154795581. It was assigned to this organization in the NPPES registry on November 23, 2015. The provider is doing business as Southern Regional Medical Center.

Where is Prime Healthcare Foundation - Southern Regional, LLC located?

Prime Healthcare Foundation - Southern Regional, LLC is located at 11 Upper Riverdale Rd SW, Riverdale, GA 30274. The listed phone number is (770) 991-8000.

What is Prime Healthcare Foundation - Southern Regional, LLC's specialty?

The primary specialty registered for this NPI is General Acute Care Hospital with taxonomy code 282N00000X.

Does Prime Healthcare Foundation - Southern Regional, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Accreditation (number 11D0021026) is associated with this NPI, valid through February 27, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Prime Healthcare Foundation - Southern Regional, LLC accept?

Health plans from Mending Health list Prime Healthcare Foundation - Southern Regional, LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Prime Healthcare Foundation - Southern Regional, LLC was last updated on September 14, 2021. NPI Profile syncs with the weekly NPPES data releases published by CMS.