Organization · Type 2 NPI

Southside Medical Center, Inc

Federally Qualified Health Center (FQHC) · Jonesboro, GA

NPI number 1821981234 Active

Practice location

178 Lee St
Jonesboro, GA 30236-3524

Call (404) 688-1350 Map

Mailing address

PO Box 6687
Atlanta, GA 30315-0687

Specialties and licenses

Taxonomy	Code	License
Federally Qualified Health Center (FQHC) Primary	261QF0400X	None listed

Federally Qualified Health Center (FQHC): Definition to come...

NPI record

NPI: 1821981234
Entity type: Organization (Type 2)
Issued: Jun 3, 2025
Last updated: Oct 17, 2025
Status: Active

Other names

<unavail>
Southside Medical Center School Based Health Center at Lee Elementary School · doing business as

Authorized official

Mr. Masresha Kassa, CPA
CFO
(404) 688-1350

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1821981234

Southside Medical Center, Inc's National Provider Identifier is 1821981234, issued on Jun 3, 2025. The primary taxonomy on file is Federally Qualified Health Center (FQHC) (261QF0400X), and the practice location is in Jonesboro, GA. The record was last updated on Oct 17, 2025.