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BON SECOURS - SOUTHSIDE MEDICAL CENTER
NPI 1720623853
General Acute Care Hospital in Petersburg, VA

Active since November 13, 2019
200 MEDICAL PARK BLVD, PETERSBURG, VA 23805(804) 765-5000 Get Directions Write a Review

NPPES record last updated: November 23, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Nov 23, 2020, Nov 6, 2020, Jan 7, 2020 and 1 more (4 updates tracked since 2019).

About Bon Secours - Southside Medical Center NPPES

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

BON SECOURS - SOUTHSIDE MEDICAL CENTER (NPI 1720623853) is a healthcare organization registered as a general acute care hospital in Petersburg, Virginia and active in the NPI registry since November 2019. The organization lists Kimberly M Ralston, System Director, as its authorized official.

NPPES Registry Identity

NPI1720623853
Entity TypeOrganization
Primary Taxonomy282N00000X
Legal Business NameBON SECOURS MERCY HEALTH PETERSBURG LLC
Location Address200 MEDICAL PARK BLVDPetersburg, VA 23805-9274
Mailing AddressPo Box 639859Cincinnati, OH 45263-9859
Phone(804) 765-5000
Organization SubpartNo
Authorized OfficialKimberly M RalstonSystem Director · (419) 996-5119
Enumeration DateNovember 13, 2019
Last NPPES UpdateNovember 23, 20204 updates tracked since enumeration
NPPES CertifiedNovember 23, 2020
✔ NPI 1720623853 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyGeneral Acute Care HospitalHospitals
Taxonomy Code282N00000X
Definition
An acute general hospital is an institution whose primary function is to provide inpatient diagnostic and therapeutic services for a variety of medical conditions, both surgical and non-surgical, to a wide population group. The hospital treats patients in an acute phase of illness or injury, characterized by a single episode or a fairly short duration, from which the patient returns to his or her normal or previous level of activity.
200 MEDICAL PARK BLVD, Petersburg, VA 23805
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Other Names 2

Doing Business AsBon Secours - Southside Medical Center
Doing Business AsSouthside Regional Medical Center

Other Providers at the Same Location NPPES 20

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

SARAH LIGHT
Student in an Organized Health Care Education/Training Program
200 MEDICAL PARK BLVD
PETERSBURG, VA 23805
Petersburg City (804) 765-5000
DOUGLAS COHRS PA-C
Physician Assistant
200 MEDICAL PARK BLVD
PETERSBURG, VA 23805
Petersburg City (703) 431-9975
SUDHA KODURU M.D.
Internal Medicine
200 MEDICAL PARK BLVD
PETERSBURG, VA 23805
Petersburg City (804) 765-5991
BRIAN WAYNE MCCAULEY PA-C
Physician Assistant
200 MEDICAL PARK BLVD
PETERSBURG, VA 23805
Petersburg City (804) 765-5000
DR. MICHAEL W CIESLINSKI M.D.
Emergency Medicine
200 MEDICAL PARK BLVD
PETERSBURG, VA 23805
Petersburg City (804) 765-5000
DR. BENJAMIN ROSS QUIGLEY MD
Emergency Medicine
200 MEDICAL PARK BLVD, EMERGENCY DEPARTMENT
PETESBURG, VA 23805
Petersburg City (804) 765-5000
MARIBEL K ABENIR CRNA-NP
Nurse Anesthetist, Certified Registered
200 MEDICAL PARK BLVD, SOUTHSIDE REGIONAL MEDICAL CENTER
PETERSBURG, VA 23805
Petersburg City (804) 765-5000
JULIANA NAW
Student in an Organized Health Care Education/Training Program
200 MEDICAL PARK BLVD
PETERSBURG, VA 23805
Petersburg City (804) 765-5000

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 Bon Secours Mercy Health Petersburg LLC's NPI number?

The NPI number for Bon Secours Mercy Health Petersburg LLC is 1720623853. It was assigned to this organization in the NPPES registry on November 13, 2019. The provider is doing business as Bon Secours - Southside Medical Center and Southside Regional Medical Center.

Where is Bon Secours Mercy Health Petersburg LLC located?

Bon Secours Mercy Health Petersburg LLC is located at 200 Medical Park Blvd, Petersburg, VA 23805. The listed phone number is (804) 765-5000.

What is Bon Secours Mercy Health Petersburg LLC's specialty?

The primary specialty registered for this NPI is General Acute Care Hospital with taxonomy code 282N00000X.

When was this NPI record last updated?

The NPPES record for Bon Secours Mercy Health Petersburg LLC was last updated on November 23, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.