Southside Family Medical Group, Llc - Medicare Primary Care in Indianapolis, IN

Southside Family Medical Group, Llc is a medicare enrolled primary clinic (Family Medicine) in Indianapolis, Indiana. The current practice location for Southside Family Medical Group, Llc is 5955 S Emerson Ave, Suite 100, Indianapolis, Indiana. For appointments, you can reach them via phone at (317) 789-9600. The mailing address for Southside Family Medical Group, Llc is 5955 S Emerson Ave, Suite 100, Indianapolis, Indiana and phone number is (317) 452-8400.

Southside Family Medical Group, Llc is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its NPI number is 1215024674. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (317) 789-9600.

Contact Information

Southside Family Medical Group, Llc
5955 S Emerson Ave
Suite 100
Indianapolis
IN 46237-2600
(317) 789-9600
(317) 789-0600

Primary Care Clinic Profile

Full NameSouthside Family Medical Group, Llc
SpecialityFamily Medicine
Location5955 S Emerson Ave, Indianapolis, Indiana
Authorized Official Name and PositionChris A Goul (PRACTICE MANAGER)
Authorized Official Contact3174528400
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Southside Family Medical Group, Llc
5955 S Emerson Ave
Suite 100
Indianapolis
IN 46237-2600

Ph: (317) 452-8400
Southside Family Medical Group, Llc
5955 S Emerson Ave
Suite 100
Indianapolis
IN 46237-2600

Ph: (317) 789-9600

NPI Details:

NPI Number1215024674
Provider Enumeration Date10/06/2006
Last Update Date10/07/2015

Medicare PECOS Information:

Medicare PECOS PAC ID2567431869
Medicare Enrollment IDO20041001000768

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Medical Identifiers

Medical identifiers for Southside Family Medical Group, Llc such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1215024674NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207Q00000XFamily Medicine (* (Not Available))Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Southside Family Medical Group, Llc acts as a billing entity for following providers:
Provider NameDavid Dale Williams
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1164490538
PECOS PAC ID: 8527012913
Enrollment ID: I20050309000215

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Provider NameRhonda Wilson Goul
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1023086725
PECOS PAC ID: 5890749287
Enrollment ID: I20050309000248

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Provider NameCynthia S Williams
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1093756348
PECOS PAC ID: 5193725828
Enrollment ID: I20070103000376

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Provider NameBrian C Ruley
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1386758639
PECOS PAC ID: 3476652975
Enrollment ID: I20070625000405

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