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

Active since October 06, 2006CLIA 15D1004974 · Microscopy
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: July 26, 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 holds a CLIA Microscopy certificate valid through October 9, 2026 and 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 ›

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
Active · expires 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.

Other Providers at the Same Location NPPES 5

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

CATHY YODER MD, LLC
Family Medicine
5955 S EMERSON AVE, SUITE 100
INDIANAPOLIS, IN 46237
Marion County (317) 426-1456
DR. DAVID D WILLIAMS M.D.
Family Medicine
5955 S EMERSON AVE, SUITE 100
INDIANAPOLIS, IN 46237
Marion County (317) 789-9600
DR. JEFFERY A ROBERTS D.D.S., M.S.D.
Dentist (Orthodontics and Dentofacial Orthopedics)
5955 S EMERSON AVE, STE. 200
INDIANAPOLIS, IN 46237
Marion County (317) 536-1365
DR. ERIC D WALLISA M.D.
Family Medicine
5955 S EMERSON AVE, 100
INDIANAPOLIS, IN 46237
Marion County (317) 789-9600
DR. WILBUR EUGENE ROBERTS D.D.S, PHD
Dentist (Orthodontics and Dentofacial Orthopedics)
5955 S EMERSON AVE, STE. 200
INDIANAPOLIS, IN 46237
Marion County (317) 536-1365

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.

Does Southside Family Medical Group, LLC hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 15D1004974) is associated with this NPI, valid through October 9, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Southside Family Medical Group, LLC accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian 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 with the weekly NPPES data releases published by CMS.