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SOUTHPARK HEART & RHYTHM CENTER LLC
NPI 1710796446
Clinic/Center - Ambulatory Surgical in Colonial Heights, VA

Active since January 07, 2025CLIA 49D2329115 · Certificate of Compliance
445 CHARLES H DIMMOCK PKWY STE 102, COLONIAL HEIGHTS, VA 23834(804) 823-2375(804) 495-4955 Get Directions Write a Review

NPPES record last updated: January 9, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Southpark Heart & Rhythm Center Llc NPPES

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

SOUTHPARK HEART & RHYTHM CENTER LLC (NPI 1710796446) is a healthcare organization registered as an ambulatory surgical in Colonial Heights, Virginia and active in the NPI registry since January 2025. The organization holds a CLIA Certificate of Compliance certificate valid through August 21, 2027 and lists Mitesh Amin, Ceo, as its authorized official.

NPPES Registry Identity

NPI1710796446
Entity TypeOrganization
Primary Taxonomy261QA1903X
Legal Business NameSOUTHPARK HEART & RHYTHM CENTER LLC
Location Address445 CHARLES H DIMMOCK PKWY STE 102Colonial Heights, VA 23834-2990
Mailing Address445 Charles H Dimmock Pkwy Ste 100Colonial Heights, VA 23834-2990 · (804) 823-2375 · Fax (804) 495-4955
Phone(804) 823-2375
Fax(804) 495-4955
Organization SubpartNo
Authorized OfficialMitesh AminCeo · (804) 400-1322
Enumeration DateJanuary 7, 2025
Last NPPES UpdateJanuary 9, 2025
NPPES CertifiedJanuary 9, 2025
✔ NPI 1710796446 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Ambulatory SurgicalAmbulatory Health Care Facilities
Taxonomy Code261QA1903X
445 CHARLES H DIMMOCK PKWY STE 102, Colonial Heights, VA 23834
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Southpark Heart & Rhythm Center Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

2

Medicare enrollment records show 2 clinicians reassign Medicare billing to Southpark Heart & Rhythm Center LLC, which bills Medicare for the services they deliver. They are listed nearest first.

Clinicians, nearest first (2)

Alexander Strand, CRNA
Certified Registered Nurse Anesthetist (CRNA)
NPI 1679053458
1250 E MARSHALL ST
Richmond, VA 23298
(804) 628-6990
✔ Accepts Medicare19 mi
Angela Quader, CRNA
Certified Registered Nurse Anesthetist (CRNA)
NPI 1760432876
988102 NEBRASKA MEDICAL CTR
Omaha, NE 68198
(402) 559-4081
✔ Accepts Medicare1,031 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 of Compliance 49D2329115

Southpark Heart And Rhythm Center · Colonial Heights, VA
Active · expires Aug 21, 2027
CLIA Number49D2329115
Laboratory TypeAmbulatory Surgery Center
Certificate Effective DateAugust 22, 2025
Certificate Expiration DateAugust 21, 2027
Laboratory DirectorJenny M. Harrell
Laboratory Phone(804) 481-9400
Laboratory LocationSouthpark Heart And Rhythm Center445 Charles H Dimmock Pkwy, Suite 102, Colonial Heights, VA 23834
CLIA data matches this NPI record on: Address
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

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 Southpark Heart & Rhythm Center LLC's NPI number?

The NPI number for Southpark Heart & Rhythm Center LLC is 1710796446. It was assigned to this organization in the NPPES registry on January 7, 2025.

Where is Southpark Heart & Rhythm Center LLC located?

Southpark Heart & Rhythm Center LLC is located at 445 Charles H Dimmock Pkwy Ste 102, Colonial Heights, VA 23834. The listed phone number is (804) 823-2375.

What is Southpark Heart & Rhythm Center LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Ambulatory Surgical, with taxonomy code 261QA1903X.

Is Southpark Heart & Rhythm Center LLC enrolled in Medicare?

Yes. Southpark Heart & Rhythm Center LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Southpark Heart & Rhythm Center LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians, all in Certified Registered Nurse Anesthetist (CRNA), reassign their Medicare billing to Southpark Heart & Rhythm Center 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Southpark Heart & Rhythm Center LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Compliance (number 49D2329115) is associated with this NPI, valid through August 21, 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 Southpark Heart & Rhythm Center LLC was last updated on January 9, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 21 months 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.