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SOUTHSIDE MEDICAL CENTER PA
NPI 1972782019
Clinic/Center in Greenville, SC

Active since October 25, 2007
3921 S HIGHWAY 14 STE A, GREENVILLE, SC 29615(864) 288-2006(864) 288-1678 Get Directions Write a Review

NPPES record last updated: October 25, 2007. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Southside Medical Center Pa NPPES

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

SOUTHSIDE MEDICAL CENTER PA (NPI 1972782019) is a healthcare organization registered as a clinic/center in Greenville, South Carolina and active in the NPI registry since October 2007. The organization lists Thaer Joudeh, Owner, as its authorized official.

NPPES Registry Identity

NPI1972782019
Entity TypeOrganization
Primary Taxonomy261Q00000X
Legal Business NameSOUTHSIDE MEDICAL CENTER PA
Location Address3921 S HIGHWAY 14 STE AGreenville, SC 29615-6138
Mailing Address3921 S Highway 14 Ste AGreenville, SC 29615-6138 · (864) 288-2006 · Fax (864) 288-1678
Phone(864) 288-2006
Fax(864) 288-1678
Organization SubpartNo
Authorized OfficialThaer JoudehOwner · (864) 288-2006
Enumeration DateOctober 25, 2007
✔ NPI 1972782019 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/CenterAmbulatory Health Care Facilities
Taxonomy Code261Q00000X
License✔ Licensed in SC · 21696
Definition
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).
3921 S HIGHWAY 14 STE A, Greenville, SC 29615
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Other Identifiers 3

Medicare UPING41785SC
Medicaid216965SC
Medicare PIN8109SC

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BlueCross BlueShield of South Carolina, First Choice Next, Molina Healthcare.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Southside Medical Center Pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Southside Medical Center PA, which bills Medicare for the services this clinician delivers.

Clinician (1)

Thaer Joudeh, MD
Internal Medicine
NPI 1851355572
3919 S HIGHWAY 14 BLDG A
Greenville, SC 29615
(864) 288-2006
✔ PECOS✔ Accepts MedicareSame address

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 Waiver 42D1032227

Southside Medical Center, PA · Greenville, SC
Expired · Oct 18, 2026
CLIA Number42D1032227
Laboratory TypePhysician Office
Certificate Effective DateOctober 19, 2024
Certificate Expiration DateOctober 18, 2026
Laboratory DirectorThaer Joudeh MD
Laboratory Phone(864) 288-2006
Laboratory LocationSouthside Medical Center, PA3919 S Hwy 14, Bldg 4, Greenville, SC 29615
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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 Medical Center PA's NPI number?

The NPI number for Southside Medical Center PA is 1972782019. It was assigned to this organization in the NPPES registry on October 25, 2007.

Where is Southside Medical Center PA located?

Southside Medical Center PA is located at 3921 S Highway 14 Ste A, Greenville, SC 29615. The listed phone number is (864) 288-2006.

What is Southside Medical Center PA's specialty?

The primary specialty registered for this NPI is Clinic/Center with taxonomy code 261Q00000X.

Is Southside Medical Center PA enrolled in Medicare?

Yes. Southside Medical Center PA is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Southside Medical Center PA?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Internal Medicine) reassigns their Medicare billing to Southside Medical Center PA. 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.

What insurance does Southside Medical Center PA accept?

Health plans from BlueCross BlueShield of South Carolina, First Choice Next and Molina Healthcare list Southside Medical Center PA as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Southside Medical Center PA was last updated on October 25, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.