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SOUTHSIDE FAMILY PRACTICE
NPI 1780700765
Family Medicine in Petersburg, VA

Active since March 22, 2007
24 S ADAMS ST, PETERSBURG, VA 23803(804) 733-3739(804) 722-0634 Get Directions Write a Review

NPPES record last updated: November 16, 2008. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Southside Family Practice NPPES

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

SOUTHSIDE FAMILY PRACTICE (NPI 1780700765) is a healthcare organization registered as a family medicine in Petersburg, Virginia and active in the NPI registry since March 2007. The organization lists Shirlene Tolbert Moten, Medical Director, as its authorized official.

NPPES Registry Identity

NPI1780700765
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameSOUTHSIDE FAMILY PRACTICE P.C.
Location Address24 S ADAMS STPetersburg, VA 23803-4525
Mailing Address24 S Adams StPetersburg, VA 23803-4525 · (804) 733-3739 · Fax (804) 722-0634
Phone(804) 733-3739
Fax(804) 722-0634
Organization SubpartNo
Authorized OfficialShirlene Tolbert MotenMedical Director · (804) 733-3739
Enumeration DateMarch 22, 2007
Last NPPES UpdateNovember 16, 2008
✔ NPI 1780700765 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in VA · 0101054986
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
24 S ADAMS ST, Petersburg, VA 23803
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Other Names 1

Other NameSouthside Family Practice

Other Identifiers 3

Medicare ID-Type UnspecifiedC06596VA · Medicare Provider Number
Medicaid005637686VA
Medicare UPINF78265VA

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

Other Providers at the Same Location NPPES

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

MRS. SHAWN L BURROW NP-C
Nurse Practitioner (Primary Care)
24 S ADAMS ST
PETERSBURG, VA 23803
Dinwiddie County (804) 732-0372

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 Family Practice P.C.'s NPI number?

The NPI number for Southside Family Practice P.C. is 1780700765. It was assigned to this organization in the NPPES registry on March 22, 2007. The provider is also known as Southside Family Practice.

Where is Southside Family Practice P.C. located?

Southside Family Practice P.C. is located at 24 S Adams St, Petersburg, VA 23803. The listed phone number is (804) 733-3739.

What is Southside Family Practice P.C.'s specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

When was this NPI record last updated?

The NPPES record for Southside Family Practice P.C. was last updated on November 16, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 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.