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SOUTHSIDE FAMILY MEDICAL GROUP, LLC
NPI 1215024674
Family Medicine in Indianapolis, IN

Active since October 06, 2006
5955 S EMERSON AVE, SUITE 100, INDIANAPOLIS, IN 46237(317) 789-9600(317) 789-0600 Get Directions Write a Review

NPPES record last updated: October 7, 2015. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Southside Family Medical Group, Llc NPPES

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

SOUTHSIDE FAMILY MEDICAL GROUP, LLC (NPI 1215024674) is a healthcare organization registered as a family medicine in Indianapolis, Indiana and active in the NPI registry since October 2006. The organization lists Chris A Goul, Practice Manager, as its authorized official.

NPPES Registry Identity

NPI1215024674
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameSOUTHSIDE FAMILY MEDICAL GROUP, LLC
Location Address5955 S EMERSON AVE, SUITE 100Indianapolis, IN 46237-2600
Mailing Address5955 S Emerson Ave, Suite 100Indianapolis, IN 46237-2600 · (317) 452-8400 · Fax (317) 452-8484
Phone(317) 789-9600
Fax(317) 789-0600
Organization SubpartNo
Authorized OfficialChris A GoulPractice Manager · (317) 452-8400
Enumeration DateOctober 6, 2006
Last NPPES UpdateOctober 7, 2015
✔ NPI 1215024674 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
5955 S EMERSON AVE, Indianapolis, IN 46237
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Other Identifiers 1

Medicare ID-Type Unspecified219130Medicare Provider Number

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Southside Family Medical Group, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

4

Medicare enrollment records show 4 clinicians reassign Medicare billing to Southside Family Medical Group, LLC, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 3 within 10 miles. They are listed nearest first.

Clinicians, nearest first (4)

David Williams, M.D.
Family Practice
NPI 1164490538
5955 S EMERSON AVE SUITE 100
Indianapolis, IN 46237
(317) 789-9600
✔ PECOS✔ Accepts MedicareSame address
Rhonda Goul, M.D.
Family Practice
NPI 1023086725
5128 E STOP 11 RD STE 38
Indianapolis, IN 46237
(317) 689-0400
✔ PECOS✔ Accepts Medicare2.0 mi
Cynthia Williams, M.D.
Internal Medicine
NPI 1093756348
8325 E SOUTHPORT RD SUITE 100
Indianapolis, IN 46259
(317) 862-6609
✔ PECOS✔ Accepts Medicare3.5 mi
Brian Ruley, MD
Family Practice
NPI 1386758639
201 CONRAD HARCOURT WAY
Rushville, IN 46173
(765) 932-7591
✔ PECOS✔ Accepts Medicare34 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 for Provider-Performed Microscopy Procedures (PPMP) 15D1004974

Southside Family Medical Group LLC · Indianapolis, IN
Expired · Oct 9, 2026
CLIA Number15D1004974
Laboratory TypePhysician Office
Certificate Effective DateOctober 10, 2024
Certificate Expiration DateOctober 9, 2026
Laboratory DirectorRhonda W. Goul
Laboratory Phone(317) 452-8400
Laboratory LocationSouthside Family Medical Group LLC5955 S Emerson Ave Ste 100, Indianapolis, IN 46237
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

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 Southside Family Medical Group, LLC's NPI number?

The NPI number for Southside Family Medical Group, LLC is 1215024674. It was assigned to this organization in the NPPES registry on October 6, 2006.

Where is Southside Family Medical Group, LLC located?

Southside Family Medical Group, LLC is located at 5955 S Emerson Ave Suite 100, Indianapolis, IN 46237. The listed phone number is (317) 789-9600.

What is Southside Family Medical Group, LLC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Southside Family Medical Group, LLC enrolled in Medicare?

Yes. Southside Family Medical Group, LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Southside Family Medical Group, LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 4 clinicians in 2 Medicare specialties reassign their Medicare billing to Southside Family Medical Group, LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Family Practice (3) and Internal Medicine (1). Of these, 1 practice at this address and 3 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Southside Family Medical Group, LLC accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Anthem Blue Cross and Blue Shield and CareSource list Southside Family Medical Group, 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 Southside Family Medical Group, LLC was last updated on October 7, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.