BON SECOURS - SOUTHSIDE MEDICAL CENTER – NPI #1720623853
General Acute Care Hospital

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.

BON SECOURS - SOUTHSIDE MEDICAL CENTER is a general acute care hospital located in PETERSBURG, VA. NPPES has assigned the NPI number 1720623853 to BON SECOURS - SOUTHSIDE MEDICAL CENTER on November 13, 2019. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “BON SECOURS - SOUTHSIDE MEDICAL CENTER” is a dba name, the actual legal business name for this organization is BON SECOURS MERCY HEALTH PETERSBURG LLC. This provider is also associated with 2 additional names listed below. The primary taxonomy selected by this provider is 282N00000X from the Health Care Provider Taxonomy code set, which is classified as General Acute Care Hospital.

The NPI profile was previously updated about 6 years ago on Nov 23, 2020. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for BON SECOURS - SOUTHSIDE MEDICAL CENTER below.

NPI Profile for
BON SECOURS MERCY HEALTH PETERSBURG LLC

NPI Number
1720623853
Enumeration Date

(more than 6 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
BON SECOURS MERCY HEALTH PETERSBURG LLC
Doing Business As (dba): BON SECOURS - SOUTHSIDE MEDICAL CENTER
Other name(s)
All associated names:
Doing Business As (dba)
BON SECOURS - SOUTHSIDE MEDICAL CENTER
Doing Business As (dba)
SOUTHSIDE REGIONAL MEDICAL CENTER
Primary location
200 MEDICAL PARK BLVD
PETERSBURG, VA 23805-9274
Phone: (804) 765-5000 Fax:
Mailing address
PO BOX 639859
CINCINNATI, OH 45263-9859
Phone: Fax:
Organization Subpart
No
Authorized Official
KIMBERLY RALSTON
SYSTEM DIRECTOR
Phone: (419) 996-5119
Updated
Certification Date
Nov 23, 2020

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
282N00000X
- General Acute Care Hospital (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.