SOUTHSIDE HEALTH CENTER
NPI 1386926004
Clinic/Center - Federally Qualified Health Center (FQHC) in Grand Rapids, MI
NPI Status: Active since September 20, 2011
Contact Information
2303 KALAMAZOO AVE SE
GRAND RAPIDS, MI
ZIP 49507
Phone: (616) 965-8390
Fax: (616) 254-8192
- Organization
- Clinic/Center
- Federally Qualified Health Center (FQHC)
- Accepts Insurance
- CLIA Number: 23D2036900
- CLIA Cert. Type: Federally Qualified Health Center
- CLIA Exp. Date: 06-08-2027
About SOUTHSIDE HEALTH CENTER
This page provides the complete NPI Profile along with additional information for Southside Health Center, a primary care provider established in Grand Rapids, Michigan operating as a Clinic/center, focusing in federally qualified health center (fqhc) . The healthcare provider is registered in the NPI registry with number 1386926004 assigned on September 2011. The practitioner's primary taxonomy code is 261QF0400X. The provider is registered as an organization and their NPI record was last updated 3 years ago. Southside Health Center operates as a Multi-Specialty Group with one or more individual practitioners, who practice different areas of specialization. The provider's is doing business as Southside Health Center. The authorized official of this NPI record is Tasha Blackmon (Ceo)
- NPI
- 1386926004
- Provider Legal Name
- CHERRY STREET SERVICES INC
- Other Organization Name
- SOUTHSIDE HEALTH CENTER
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 2303 KALAMAZOO AVE SE GRAND RAPIDS, MI 49507
- Location Phone
- (616) 965-8390
- Location Fax
- (616) 254-8192
- Mailing Address
- 100 CHERRY ST SE GRAND RAPIDS, MI 49503
- Mailing Phone
- (616) 965-8200
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- Yes
- Enumeration Date
- 09-20-2011
- Last Update Date
- 08-25-2023
- Code Navigator
A primary care provider (PCP) like Southside Health Center sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc .
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Clinic/Center Federally Qualified Health Center (FQHC)
- Taxonomy Code
- 261QF0400X
- Type
- Ambulatory Health Care Facilities
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 101YA0400X | Behavioral Health & Social Service Providers | Counselor | |
| 2 | 101YM0800X | Behavioral Health & Social Service Providers | Counselor | |
| 3 | 103TA0400X | Behavioral Health & Social Service Providers | Psychologist | |
| 4 | 103TC0700X | Behavioral Health & Social Service Providers | Psychologist | |
| 5 | 1041C0700X | Behavioral Health & Social Service Providers | Social Worker | |
| 6 | 163W00000X | Nursing Service Providers | Registered Nurse | |
| 7 | 207LA0401X | Allopathic & Osteopathic Physicians | Anesthesiology |
Group Taxonomy 193200000X MULTI-SPECIALTY GROUP
This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Choice Bronze HSA - HMO
- Choice Bronze HSA + Vision + Adult Dental - HMO
- Clear Gold - HMO
- Clear Gold + Vision + Adult Dental - HMO
- Complete Gold - HMO
- Complete Gold + Vision + Adult Dental - HMO
- Complete Silver - HMO
- Complete Silver + Vision + Adult Dental - HMO
- Everyday Bronze - HMO
- Everyday Bronze + Vision + Adult Dental - HMO
- Standard Expanded Bronze - HMO
- Standard Expanded Bronze + Vision + Adult Dental - HMO
- Standard Gold - HMO
- Standard Gold + Vision + Adult Dental - HMO
- Standard Silver - HMO
- Standard Silver + Vision + Adult Dental - HMO
- Clear Silver - HMO
- Elite Gold - HMO
- Elite Gold + Vision + Adult Dental - HMO
- Everyday Gold - HMO
- Everyday Gold + Vision + Adult Dental - HMO
- Standard Gold - HMO
- Standard Gold + Vision + Adult Dental - HMO
- Standard Silver - HMO
- Standard Silver + Vision + Adult Dental - HMO
- Complete Gold - HMO
- Complete Gold + Vision + Adult Dental - HMO
- Elite Gold - HMO
- Elite Gold + Vision + Adult Dental - HMO
- Focused Silver - HMO
- Focused Silver + Vision + Adult Dental - HMO
- Standard Gold - HMO
- Standard Gold + Vision + Adult Dental - HMO
- Standard Silver - HMO
- Standard Silver + Vision + Adult Dental - HMO
- Blue Cross� Local HMO Bronze Extra - HMO
- Blue Cross� Local HMO Bronze Secure - HMO
- Blue Cross� Local HMO Silver Extra - HMO
- Blue Cross� Local HMO Silver Saver - HMO
- Blue Cross� Preferred HMO Bronze Extra - HMO
- Blue Cross� Preferred HMO Bronze Saver HSA - HMO
- Blue Cross� Preferred HMO Bronze Secure - HMO
- Blue Cross� Preferred HMO Gold - HMO
- Blue Cross� Preferred HMO Gold Extra - HMO
- Blue Cross� Preferred HMO Silver - HMO
- Blue Cross� Preferred HMO Silver Extra - HMO
- Blue Cross� Preferred HMO Silver Saver - HMO
- Blue Cross� Preferred HMO Value - HMO
- Blue Cross� Select HMO Bronze Extra - HMO
- Blue Cross� Select HMO Bronze Saver HSA - HMO
- Blue Cross� Select HMO Bronze Secure - HMO
- Blue Cross� Select HMO Silver - HMO
- Blue Cross� Select HMO Silver Extra - HMO
- Blue Cross� Select HMO Silver Saver - HMO
- Blue Cross� Select HMO Value - HMO
- Blue Cross� Premier PPO Bronze Extra - PPO
- Blue Cross� Premier PPO Bronze Saver HSA - PPO
- Blue Cross� Premier PPO Bronze Secure - PPO
- Blue Cross� Premier PPO Gold - PPO
- Blue Cross� Premier PPO Gold Extra - PPO
- Blue Cross� Premier PPO Silver - PPO
- Blue Cross� Premier PPO Silver Extra - PPO
- Blue Cross� Premier PPO Silver Saver HSA - PPO
- Blue Cross� Premier PPO Value - PPO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Areas of Expertise
The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.
Medication assisted treatment, methadone; weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing, if performed (provision of the services by a medicare-enrolled opioid treatm
Periodic assessment; assessing periodically by qualified personnel to determine the most appropriate combination of services and treatment (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for
Take-home supply of methadone; up to 7 additional day supply (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for primary procedure
Medication Assisted Treatment (MAT) with methadone is a comprehensive approach to manage opioid addiction. It includes weekly methadone dispensing, substance use counseling, individual and group therapy sessions, and toxicology tests as needed, all provided by a Medicare-enrolled opioid treatment program.
This service was performed 1,218 times for 39 patientsPeriodic assessment is a routine check-up by trained professionals to determine the best mix of services and treatments for your health needs. This is typically provided by a Medicare-enrolled opioid treatment program. It's listed separately in addition to your main treatment code. This ensures you receive the most suitable care for your situation.
This service was performed 161 times for 38 patientsThis service provides an additional 7-day supply of methadone, a medication used to treat opioid addiction, for patients to take at home. It's provided by a Medicare-enrolled opioid treatment program. This service is billed separately from the main treatment procedure.
This service was performed 257 times for 27 patientsCLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 23D2036900
- Facility Type
- Federally Qualified Health Center
- Certificate Effective Date
- June 09, 2025
- Certificate Expiration Date
- June 08, 2027
- Laboratory Director
- JENNY L. BUSH
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Southside Health Center to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1386926004, we treat the final digit (4) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 56. The final step is to find the difference between that total and the next multiple of ten (60 - 56 = 4).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 56 is 60. The difference is the calculated check digit.
Other Providers at the Same Location
The following 20 providers are registered at the same or a nearby location.
GRAND RAPIDS, MI 49507
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1386926004, enumerated as an "organization" on September 20, 2011.
The provider is located at 2303 KALAMAZOO AVE SE GRAND RAPIDS, MI 49507 and the phone number is (616) 965-8390.
Clinic/Center with taxonomy code 261QF0400X and a focus in Federally Qualified Health Center (FQHC).
The provider might be accepting Accepts: Ambetter from Buckeye Health Plan, Ambetter from. Please consult your insurance carrier or call the provider to verify.
