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DINWIDDIE MEDICAL CENTER
NPI 1487867206
Clinic/Center - Federally Qualified Health Center (FQHC) in Dinwiddie, VA

Active since May 08, 2007CLIA 49D0999982 · Microscopy
13855 COURTHOUSE RD, DINWIDDIE, VA 23841(804) 469-3731(804) 469-5307 Get Directions Write a Review

NPPES record last updated: February 7, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Feb 7, 2024, Nov 25, 2015 (2 updates tracked since 2015).

About Dinwiddie Medical Center NPPES

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

DINWIDDIE MEDICAL CENTER (NPI 1487867206) is a healthcare organization registered as a federally qualified health center (fqhc) in Dinwiddie, Virginia and active in the NPI registry since May 2007. The organization holds a CLIA Microscopy certificate valid through May 29, 2028 and lists April King, Ceo, as its authorized official.

NPPES Registry Identity

NPI1487867206
Entity TypeOrganization
Primary Taxonomy261QF0400X
Legal Business NameSOUTHERN DOMINION HEALTH SYSTEM, INC.
Location Address13855 COURTHOUSE RDDinwiddie, VA 23841-2254
Mailing AddressPo Box 70Victoria, VA 23974-0070 · (434) 696-2165 · Fax (434) 696-1378
Phone(804) 469-3731
Fax(804) 469-5307
Organization SubpartYes
Authorized OfficialApril KingCeo · (434) 696-2165
Enumeration DateMay 8, 2007
Last NPPES UpdateFebruary 7, 20242 updates tracked since enumeration
NPPES CertifiedFebruary 7, 2024
✔ NPI 1487867206 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Federally Qualified Health Center (FQHC)Ambulatory Health Care Facilities
Taxonomy Code261QF0400X
13855 COURTHOUSE RD, Dinwiddie, VA 23841
Open in Google Maps ↗

Other Names 1

Doing Business AsDinwiddie Medical Center

Other Identifiers 1

Medicaid007604025VA

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) 49D0999982

Dinwiddie Medical Center Sdhs Inc · Dinwiddie, VA
Active · expires May 29, 2028
CLIA Number49D0999982
Laboratory TypeFederally Qualified Health Center
Certificate Effective DateMay 30, 2026
Certificate Expiration DateMay 29, 2028
Laboratory DirectorHyo K. Park
Laboratory Phone(434) 696-2165
Laboratory LocationDinwiddie Medical Center Sdhs Inc13855 Courthouse Road, Dinwiddie, VA 23841
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.

AMANDA RUSSELL
Family Medicine
13855 COURTHOUSE RD
DINWIDDIE, VA 23841
Dinwiddie County (804) 469-3731
HEATHER M. GIGON NP
Nurse Practitioner (Family)
13855 COURTHOUSE RD
DINWIDDIE, VA 23841
Dinwiddie County (804) 469-3731
DR. HYO KWON PARK D.O.
Family Medicine
13855 COURTHOUSE RD
DINWIDDIE, VA 23841
Dinwiddie County (804) 469-3731
MS. ELIZABETH STANLEY MSN, APRN, FNP-C
Nurse Practitioner (Family)
13855 COURTHOUSE RD
DINWIDDIE, VA 23841
Dinwiddie County (804) 469-3731
DR. JENNIFER A CARDONE M.D.
Specialist
13855 COURTHOUSE RD
DINWIDDIE, VA 23841
Dinwiddie County (804) 469-3731

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 Southern Dominion Health System, Inc.'s NPI number?

The NPI number for Southern Dominion Health System, Inc. is 1487867206. It was assigned to this organization in the NPPES registry on May 8, 2007. The provider is doing business as Dinwiddie Medical Center.

Where is Southern Dominion Health System, Inc. located?

Southern Dominion Health System, Inc. is located at 13855 Courthouse Rd, Dinwiddie, VA 23841. The listed phone number is (804) 469-3731.

What is Southern Dominion Health System, Inc.'s specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Federally Qualified Health Center (FQHC), with taxonomy code 261QF0400X.

Does Southern Dominion Health System, Inc. hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 49D0999982) is associated with this NPI, valid through May 29, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Southern Dominion Health System, Inc. was last updated on February 7, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.