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SOUTHSIDE PEDIATRICS, P.C.
NPI 1366525040
Legal Medicine in Farmville, VA

Active since October 24, 2006CLIA 49D0688031 · Waiver
502 BEECH ST, FARMVILLE, VA 23901(434) 392-9438(434) 392-7630 Get Directions Write a Review

NPPES record last updated: June 9, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jun 9, 2022, Jan 26, 2021 (2 updates tracked since 2021).

About Southside Pediatrics, P.c. NPPES

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

SOUTHSIDE PEDIATRICS, P.C. (NPI 1366525040) is a healthcare organization registered as a legal medicine in Farmville, Virginia and active in the NPI registry since October 2006. The organization holds a CLIA Waiver certificate valid through November 30, 2027 and lists Teresita Dionisio, Owner, as its authorized official.

NPPES Registry Identity

NPI1366525040
Entity TypeOrganization
Primary Taxonomy173000000X
Legal Business NameSOUTHSIDE PEDIATRICS, P.C.
Location Address502 BEECH STFarmville, VA 23901-1222
Mailing Address502 Beech StFarmville, VA 23901-1222 · (434) 392-9438 · Fax (434) 392-7630
Phone(434) 392-9438
Fax(434) 392-7630
Organization SubpartNo
Authorized OfficialTeresita DionisioOwner · (434) 392-9438
Enumeration DateOctober 24, 2006
Last NPPES UpdateJune 9, 20222 updates tracked since enumeration
NPPES CertifiedJune 9, 2022
✔ NPI 1366525040 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyLegal MedicineOther Service Providers
Taxonomy Code173000000X
License✔ Licensed in VA · 0101035421
Definition
The specialty areas of medicine concerned with matters of, and relations with, substantive law and legal institutions; such as the conduct of medical examinations at crime scenes, performance of autopsies, giving of expert medical testimony in judicial proceedings, medical treatment of inmates of penal institutions, the practice of trauma medicine in law enforcement settings, and other clinical practice and medical science applications in the fields of law, law enforcement, and corrections.
502 BEECH ST, Farmville, VA 23901
Open in Google Maps ↗

Other Identifiers 4

Medicaid006702767VA
Other081150VA · Dr D Anthem#
Medicaid010018579VA
Other99161VA · Optima # Dr D

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

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 Waiver 49D0688031

Southside Pediatrics · Farmville, VA
Active · expires Nov 30, 2027
CLIA Number49D0688031
Laboratory TypePhysician Office
Certificate Effective DateDecember 1, 2025
Certificate Expiration DateNovember 30, 2027
Laboratory DirectorTeresita C. Dionisio
Laboratory Phone(434) 392-9438
Laboratory LocationSouthside Pediatrics502 Beech Street, Farmville, VA 23901
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 4

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

SOUTHSIDE MEDICAL PRACTICE PLLC
Internal Medicine
502 BEECH ST
FARMVILLE, VA 23901
Prince Edward County (434) 392-9438
DR. VICTOR ROMEO CLEMENTE ADANIEL MD
Internal Medicine
502 BEECH ST
FARMVILLE, VA 23901
Prince Edward County (434) 392-9438
TERESA GAIL GEORGE LPC
Behavior Analyst
502 BEECH ST
FARMVILLE, VA 23901
Prince Edward County (434) 414-8308
TERESITA CAPATI DIONISIO M.D.
Pediatrics
502 BEECH ST
FARMVILLE, VA 23901
Prince Edward County (434) 392-9438

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 Pediatrics, P.C.'s NPI number?

The NPI number for Southside Pediatrics, P.C. is 1366525040. It was assigned to this organization in the NPPES registry on October 24, 2006.

Where is Southside Pediatrics, P.C. located?

Southside Pediatrics, P.C. is located at 502 Beech St, Farmville, VA 23901. The listed phone number is (434) 392-9438.

What is Southside Pediatrics, P.C.'s specialty?

The primary specialty registered for this NPI is Legal Medicine with taxonomy code 173000000X.

Does Southside Pediatrics, P.C. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 49D0688031) is associated with this NPI, valid through November 30, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Southside Pediatrics, P.C. was last updated on June 9, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.